Pearls From: Mary Rosser, MD

Ob/gyns may be the primary provider for women's healthcare throughout their lives, and can play a role in the prevention of heart disease before, during, and after a patient's pregnancy. In this exclusive MedPage Today video, Mary Rosser, MD, of Montefiore Health System, discusses how ob/gyns can make a difference in women's heart health, and how potential multi-specialty collaboration can ensure that women with risk factors for heart disease during their pregnancy receive the most complete care.

Following is a transcript of her remarks:

Obstetricians and gynecologists can play a significant role in preventing heart disease, including hypertension among women, especially younger women. The earlier that we have an impact, the better, and the healthier that that woman will be throughout her life.

Data has shown that women see their OB/GYN as their sole provider of healthcare. We have a unique and personal relationship with women, and therefore, we’re able to impact their overall health and wellbeing. 90% of women have more than one risk factor for the development of heart disease over their lifetime. Some we can control and some we cannot control. I tell women, “I can’t control your age, your gender, your race, and your family history.”

But it is up to us as individuals to control our lifestyle choices. It’s important for us to take these risk factors and look at every individual woman and take this at every opportunity that we have. We have touch points where we see women throughout their lifetime, from adolescence through their reproductive years, menopause and beyond. At each one of these visits, we can mention risk factors for heart disease, which by the way, are risk factors for many chronic diseases including cancer.

We can also explain to women at each visit that what they do in their teens, their 20s, and their 30s, will set the pace or the tone for how they live their 40s, 50s, and 60s. So it is up to us as women’s healthcare providers to make an impact on women’s heart disease as they go through life.

There are conditions within a woman’s life that predispose them for having an increased risk of heart disease. Preeclampsia and eclampsia, which develop during pregnancy, are among this list. So it’s very important for us as physicians that take care of women to identify these women very early on so that we can begin the prevention and early intervention process. A lot of data has been emerging in many reports that suggest that the hypertensive disorders of pregnancy including gestational hypertension, preeclampsia and eclampsia increase a woman’s risk up to five fold of developing a lifetime risk of cardiovascular disease, including hypertension.

So it is very important that, as obstetricians and gynecologists, we identify these women so that they have early screening. We can aim to prevent further disease development or start early intervention. It’s very important to follow up these women very closely and circles are starting to refer patients such as these to their internist for immediate follow up, and then long-term care, and also to cardiologists, depending on what the situation is.

I think that over time we will develop a better system that is full of treatment and prevention strategies that we can use with patients, because the idea is to prevent further progress of disease rather than treating a full-blown chronic disease later in life.

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