When it comes to designing and optimizing their roster of benefits, leading employers are recognizing the importance of taking a more expansive view of women’s health. This broader and clearer perspective grasps that women face higher risks than men for certain serious health conditions, including the perennial #1 killer of women in the U.S.: heart disease.
Heart disease kills more women than all forms of cancer combined — including breast cancer — and in 2020 it was responsible for about 1 in every 5 female deaths. About 60 million women in the U.S. across all age groups have some form of heart disease. Yet despite this prevalence, only 44 percent of women see heart disease as their most dangerous health threat.
Preeclampsia and Heart Disease
Women can also experience conditions that heighten their risk of heart disease, such as preeclampsia. This refers to the development of high blood pressure and signs of kidney, liver, or other organ damage that occurs in women after the 20th week of pregnancy. In some cases, preeclampsia may occur just after delivery (known as postpartum preeclampsia).
Preeclampsia and related hypertensive disorders of pregnancy impact 5-8% of all births in the U.S., and is responsible for over 70,000 maternal deaths and 500,000 fetal deaths worldwide every year. Preeclampsia can also lead to serious heart health issues for affected women later in life. This includes increased risk of cardiovascular disease:
- A study published in 2020 in the American Heart Association journal Hypertension analyzed 508,422 pregnant women, and found that women who developed preeclampsia during their first pregnancy were 2x as likely to experience heart failure later in life. Women who developed preeclampsia in more than one pregnancy were 4x as likely.
- A study published in 2023 by Truveta Research analyzed nearly 500,000 female patients, and found that Black women with preeclampsia were 2x more likely to have heart failure compared to white women with preeclampsia. Black women with preeclampsia were also 1.4x times more likely to have heart failure than Asian women with preeclampsia.
- A study published in 2023 in the European Journal of Preventive Cardiology analyzed 1,157,666 deliveries, and found that up to 2 percent of women with preeclampsia in their first pregnancy had a heart attack or stroke within two decades of delivery, compared with up to 1.2 percent of unaffected women. Differences in risk became apparent seven years after delivery.
- A study published in 2023 in The BMJ analyzed 2,195,266 deliveries and found that women who experienced any of five major adverse pregnancy outcomes (which included preeclampsia) showed an increased risk for ischemic heart disease up to 46 years after delivery. Ischemic heart disease, also called coronary heart disease (CHD) or coronary artery disease, refers to heart problems caused by the narrowing of the arteries that supply blood to the heart muscle (coronary arteries).
What Employers Can Do
Although there is no way to prevent preeclampsia, there are several practical ways that employers can help the women in their workforce reduce their risk of preeclampsia, and improve their overall heart health:
- Develop programs that support healthy lifestyle choices, both before and during pregnancy. Programs targeted at diet, exercise, and weight loss have numerous health benefits, including reducing the risk of developing preeclampsia. In one study of women with a history of preeclampsia, weight reduction before their next pregnancy decreased the risk of recurrent preeclampsia. Similarly, pregnant women who exercise had a lower risk of preeclampsia. Finally, encouraging (or better yet, at times catering) a Mediterranean-style diet that focuses on vegetables, fruits, legumes, nuts, olive oil, whole grains and fish may lower the risk for preeclampsia, especially in Black women.
- Ensure comprehensive medical coverage for prenatal care, and encourage pregnant employees to utilize this benefit. Among the many reasons that prenatal care is important is that it allows doctors to screen for conditions like preeclampsia and institute treatments that may help. For example, studies have also shown that treating high blood pressure during pregnancy can reduce the risk of preeclampsia, and is associated with better pregnancy outcomes. Other treatments, like aspirin, may be used to prevent preeclampsia in certain women, and following closely with an obstetrician is the best way for women to learn what treatment is most appropriate for them.
- If possible, reduce or eliminate rotating shifts, fixed night shifts, and longer hours for pregnant women, as all have been linked to an increased risk of preeclampsia and other adverse pregnancy outcomes.
- Provide resources, such as programs and tools, to help pregnant women manage and reduce stress. Research has found that high psychosocial stress can increase the risk of preeclampsia. When a pregnant woman has both increased levels of stress and chronic hypertension, this combination can increase the risk of preeclampsia up to 20-fold.
The Final Word
The U.S. healthcare system regularly fails to meet the needs of women of reproductive age. Employers that take an expanded view of women’s health — which includes (but is not limited to) supporting heart health to reduce the risk of preeclampsia — will raise the bar and lead the way.