Abstract 19161: Pregnancy-Induced Disorders Identify High-Risk Women who Benefit from Cardiovascular Screening: Results from the Women's Heart Health Initiative, an OB/GYN Screening Pilot Program

Abstract

Introduction. Prior studies have suggested that pregnancy-induced conditions (PIC) such as hypertension, diabetes, and pre-eclampsia are associated with increased long-term cardiovascular (CV) risk. However, many women see their obstetrician/gynecologist (OB/GYN) as their primary care physician, and their CV risk factors may be underdiagnosed and undertreated. Our hypothesis was that women presenting to an outpatient OB/GYN clinic with a history of PIC would have a higher prevalence of CV risk factors and symptoms compared with women with no PIC. Methods. From May 2010 to January 2012, 2,236 patients in 16 OB/GYN centers completed a simple one-page CV survey. Blood pressure was measured in all patients with no prior screening. We compared responses in 295 patients with a history of PIC versus 1,939 patients with no PIC. Results. Compared to women with no PIC, women with PIC were younger but more likely to have hypertension, diabetes, a family history of premature coronary artery disease, and to be overweight (Table). Women with PIC were more likely to report CV symptoms such as exertional chest pain, dyspnea or claudications. A similar proportion of women with and without PIC considered their OBGYN their primary care physician (15.1% vs. 18.7%, p=NS). As a result of screening, 33.5% of women with a history of PIC (vs. 23.9% no PIC, p=0.006) were referred to another health care provider (e.g. primary care physician, cardiologist, endocrinologist). Conclusion. Amongst middle aged women screened in community OB/GYN clinics, PIC was associated with a higher prevalence of CV risk factors and symptoms, but with no difference in whether the OB/GYN was the primary care provider. Specific CV screening in this setting may improve the early diagnosis and treatment of CV risk factors and disease in this high risk group of patients.