The Delivery Room Is Women’s First Cardiac Exam

Key Takeaway

Across 55 European nations in 2023, women accounted for 55% of cardiovascular disease cases and half of all cardiovascular deaths; yet their clinical profile differed markedly from that of men. Hypertensive disorders of pregnancy represented 25% of all incident cardiovascular cases in women, establishing gestation as one of the most vital—and chronically neglected—windows for lifelong cardiovascular prevention.

The Blood Pressure Reading No One Followed Up On

Consider a 33-year-old teacher at 36 weeks of gestation. She develops a pounding headache, and her blood pressure registers 158/104 mmHg. The diagnosis is preeclampsia—a pregnancy-specific disorder marked by sudden-onset hypertension and widespread vascular endothelial injury. Labor is induced, a healthy baby is delivered, and within several weeks her blood pressure readings normalize. She is discharged home with profound relief. No clinician, however, schedules a follow-up blood pressure assessment for the subsequent year, or the year after that.

This silent fracture in the continuum of care now has a definitive figure attached to it. In a comprehensive analysis of cardiovascular disease across Europe, maternal hypertensive disorders accounted for 1 in every 4 new cardiovascular cases among women^[1]. Cardiovascular disease remains the leading cause of mortality among women globally; nonetheless,…