In 2017, the American Heart Association and American College of Cardiology lowered their threshold guidelines for what qualifies as hypertension. Not surprisingly, some people have met the new thresholds with skepticism: are tiny elevations in blood pressure really that serious?
In a word, says Dr. Janet Catov: Yes. Heart disease — the number one killer of women — is a primary example of the casualties caused by the longtime practice of focusing more scientific research on men. Because women were thought to be relatively immune from heart disease, they were understudied, to their peril.
“It turns out that heart disease is actually the leading killer of women. It kills more women than all cancers combined,” says Catov, an epidemiologist with Magee-Womens Research Institute who has studied the role pregnancy plays in predicting future cardiovascular health.
Certain complications, such as preeclampsia and pre-term birth, are linked to cardiovascular disease in the mother a decade after birth, she notes. Even tiny elevations in blood pressure, too low to meet the threshold for hypertension, can portend future trouble.
To use that information constructively, Catov’s group of scientists is teaching women to take their own blood pressure at home and that its measurement is as important as weight.
“Women can take that information to their physicians and begin to incorporate that into their plan for their own health,” she says. Additionally, “it can begin to teach us how small elevations in blood pressure might actually be related to long-term risk for things like a first heart attack.”
In the not-too-distant past, critics might have suggested that such small changes in blood pressure were unimportant, Catov notes.
“Here at Magee, we’re saying, ‘We can study women across the lifespan. These small differences now can accrue to have really important, significant impacts on health in the long run. We can quantify what that risk might look like. We can begin to think about how we change that risk,’” she says.
“Not that long ago, obstetrics was thought to be a different universe than heart disease,” she notes, but research from Magee-Women’s Research Institute is demonstrating that there could well be a link. “Now we’re studying them in the same context. I think that is a bit of a breakthrough.”
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