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<\/a><\/p>\nReview: Pregnancy- the ultimate cardiovascular stress test<\/a>. Image Credit: lotos_land \/ Shutterstock<\/p>\n In a recent comprehensive review published in the journal npj Cardiovascular Health<\/a>, researchers synthesize decades of research on pregnancy and cardiovascular health to illustrate how pregnancy serves as the ultimate cardiovascular stress test.<\/p>\n The review\u2019s findings demonstrate that pregnancy-related complications like preeclampsia and gestational diabetes are not just temporary hurdles on the path to parenthood, but important early indicators of a woman\u2019s future heart problems.<\/p>\n The review further identified significant evidence gaps in previous literature, highlighting the underrepresentation of women of reproductive age and pregnant or lactating women. The authors ultimately call for better postpartum screening and the crucial inclusion of younger women in future clinical trials.<\/p>\n Background<\/p>\n Despite cardiovascular disease (CVD) being documented as the leading cause of female mortality globally, the field continues to be viewed through a primarily male-centric lens. Recent reports indicate that women are startlingly underrepresented in medical research and clinical care, an observation attributed to historical concerns surrounding associations between cardiovascular clinical trials and teratogenicity, the scientific word for \u201crisk of causing birth defects\u201d.<\/p>\n As a result, modern medicine relies heavily on data gathered from postmenopausal women and older men, leaving a significant knowledge gap regarding women of childbearing age. This disparity was highlighted in a recent analysis, which found that women accounted for only 41% of participants in cardiovascular trials, with an even smaller proportion (30.6%) of trials involving patients aged 19 to 55.<\/p>\n Recent research increasingly supports the view that pregnancy induces substantial hemodynamic and hormonal shifts in pregnant women, effectively acting as a nine-month stress test that may potentially unmask subclinical, hidden cardiovascular risks.<\/p>\n About the review<\/p>\n The present comprehensive review sought to overcome the limitations of the conventional pregnancy-cardiovascular literature by synthesizing existing evidence, clinical literature, maternal health records, and scientifically grounded international guidelines to map the poorly understood interplay between pregnancy and heart health, and to further reveal significant differences in the recommendations of international health agencies.<\/p>\n The review discussed several physiological endpoints reported in previous research, including changes in peripheral vascular resistance (PVR), cardiac output, and left ventricular wall thickness during both gestation and labor periods.<\/p>\n The review also described established risk stratification tools, e.g., the modified World Health Organization (WHO) classification, used to assess cardiovascular risk in pregnancy, and summarized evidence on specific cardiovascular events such as acute myocardial infarction (AMI), arrhythmias, and peripartum cardiomyopathy<\/a> (PPCM).<\/p>\n