Black women susceptible to pregnancy-related heart failure
Peripartum cardiomyopathy (PPCM) is a form of heart failure that occurs in the last month of pregnancy or up to five months following delivery. This condition, which can be life-threatening, seems to be more common among African American women compared to those of other races. That's the main finding of a study by researchers from Perelman School of Medicine at the University of Pennsylvania.
“Not only are African American women at twice the risk, but in this study we found they also took twice as long to recover, they were twice as likely to worsen before getting better after diagnosis, and they were twice as likely to fail to recover altogether, meaning their heart failure persisted for months following delivery,” said senior author Zoltan Arany, MD, PhD, an associate professor of Cardiovascular Medicine and director of the Cardiovascular Metabolism Programme.
This retrospective study published in JAMA Cardiology is the first to pinpoint racial disparities associated with severity and effects of PPCM. Researchers evaluated the electronic medical records of 220 patients who had been diagnosed with PPCM or heart failure between January 1986 and December 2016 at the Hospital of the University of Pennsylvania, Pennsylvania Hospital and Penn Presbyterian Medical Center. The team analysed patient demographics such as age and ethnicity, in addition to the patient’s ejection fraction (EF) — the measurement of the percentage of blood leaving the heart each time it contracts — and whether the patient delivered twins, or had a caesarean delivery.
The Penn team found that African American women presented with symptoms of PPCM at a younger age — the average age was 27 years old — than non-African American patients, who averaged 31 years old at the time of diagnosis. African American patients also presented with a lower EF, and they continued to have a lower EF as compared to non-African American patients even after follow-up. In addition, a greater portion of African-American women had worsening EF even after they began treatment, which caused to them take longer to recover than the others.
Another interesting finding from this study was the correlation between twin pregnancies, caesarean delivery, gestational hypertension and a PPCM diagnosis. African American women were found to be less likely to have twin pregnancies and to deliver via caesarean than their non-African American counterparts. But, African American women were more likely to experience chronic hypertension, which could be a risk indicator of PPCM.
The study opens the door for further research on this subject to determine why these women are more at risk, according to Jennifer Lewey, MD, MPH, an assistant professor of Cardiovascular Medicine and director of the Penn Women’s Cardiovascular Center. The findings highlight the need to "identify how we can proactively diagnose and potentially prevent such a dangerous diagnosis in this at-risk patient population," Dr. Lewey added.
Source: Penn Medicine
Image Credit: Pixabay
Published on : Tue, 17 Oct 2017
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