Monica Cantu and her husband were thrilled when they learned they were expecting twins, a boy and a girl.
The couple couldn’t wait to meet their babies. During a doctor’s appointment, Cantu discovered that her son was small. At 23 weeks, the doctors noticed something was wrong with the baby’s umbilical cord. The blood did not flow properly through the umbilical cord.
Doctors warned Cantu to expect the worst. But she hoped for two healthy babies.
A few weeks later, Cantu felt a strange tingling and numbness in her face. She and her husband were rushed to the hospital. Tests showed her liver enzymes were elevated. Cantu’s blood pressure was high at first, but a second reading came back normal, she says.
When she did not improve after two days, doctors prepared Cantu for an emergency delivery. She was only 25 weeks along.
“There was panic,” said Cantu, who lives in Katy, Texas. “I thought, ‘These babies can’t come now!’ My son was estimated to be only 12 ounces.”
Cantu’s daughter, Amelia, was born strong and screaming, she remembers. But baby Roman was born quietly. He clung to life but died two days later.
Tests conducted during the ordeal revealed Cantu’s diagnosis: serious preeclampsia. High blood pressure is a defining feature of this pregnancy complication. Elevated liver enzymes and other signs of organ damage are also symptoms.
“Losing my son was devastating,” Cantu said. “I was left with so many questions. I carried so much guilt with me, as if my body had failed me.’
High blood pressure during pregnancy is a growing problem for expectant mothers in the US and especially for Latinas.
Hypertensive disorders of pregnancy (HDP), including preeclampsia and gestational hypertension, more than doubled in the US between 2007 and 2019, according to a study study published in the Journal of the American Heart Association. Rates increased for all women, but Latina/Hispanic women had the strongest increase, with more than 60 cases per 1,000 live births.
Even more worrying, new data links heart irregularities in older Spanish women to high blood pressure they had during pregnancy years earlier.
“There are significant changes in heart structure and function in Latina women who had high blood pressure during pregnancy, meaning their heart has abnormalities,” says Odayme Quesada, MD, medical director of Christ Hospital Women’s Heart Center in Cincinnati and main author of the book studypublished in Hypertension.
The findings are important because such differences can predict cardiovascular events later in life, such as heart failure and even death, Quesada explains.
For the study, researchers analyzed the hearts of 5,168 Hispanic/Latino women with previous pregnancies and whose average age was about 60. The results showed that previous HDP was associated with changes in the way the heart contracts and relaxes, increased heart wall thickness, and increased heart wall thickness. velocities of abnormal geometry in the left ventricle of the heart.
The study helps answer the question of why women with hypertension during pregnancy often develop future heart problems, Quesada says. Up to 20% of women with HDP will develop high blood pressure six months after giving birth, and their lifetime risk for chronic hypertension increases tenfold, studies show.
“Prior to our study, the question was: Do abnormalities in the structure and function of the heart develop because of the HDP itself or because many of the women with HDP subsequently develop chronic high blood pressure?” she says. “Our research helps fill the gaps.”
During her pregnancy, Cantu’s blood pressure was sometimes high during prenatal visits but then dropped.
The fluctuation was explained away as “white coat syndrome,” she says. The term refers to anxiety or nervousness during doctor visits that can increase blood pressure. Other symptoms she reported to doctors, such as extreme itching and headaches, were dismissed as typical pregnancy symptoms.
Cantu says she didn’t know much about it at the time preeclampsia. She had heard the term before, but didn’t know how serious it was. None of her relatives had experienced the complication.
Lack of awareness may be one of the reasons why HDP rises faster in Latina women. Research shows Hispanic adults in the US have the lowest rates of hypertension awareness and management compared to white, black, and Asian adults.
Latinos are also less likely to have their high blood pressure under control, says Adriana Maldonado, PhD, assistant professor at the Mel and Enid Zuckerman College of Public Health at the University of Arizona.
The reasons behind poor control of high blood pressure are complex, says Maldonado, lead author of a recent research on the management of hypertension among Latinos. Some of the major barriers include lack of time to make lifestyle changes, health insurance limitations, financial constraints, and language barriers when interacting with healthcare providers. Limited access to health care, culturally rich diets and hesitation to seek preventive care are also factors.
Social determinants of health largely explain the differences, Maldonado says. “That is, the documented low rates of uncontrolled hypertension among Latinos are the result of the intersection of environmental, social, economic, and interpersonal factors.”
Lowering your risk of developing hypertension during pregnancy and taking action to control your blood pressure after pregnancy is critical, Maldonado and Quesada say. Prevention tips include:
Adopt a heart-healthy diet. An eating style that’s beneficial to your heart can reduce your risk of high blood pressure, says Maldonado. The Dietary Approaches to Stop Hypertension (DASH) eating plan is one option. DASH foods are rich in calcium, magnesium and potassium. The plan also emphasizes vegetables, fruits and whole grains.
Make exercise a priority. It’s important to incorporate exercise into your lifestyle, says Quesada. The American Heart Association recommends 150 minutes of physical activity per week.
Monitor your blood pressure. If you suffered from hypertension during pregnancy, keep a close eye on your blood pressure after delivery, Quesada advises. It is a good idea to own your own blood pressure cuff and monitor your blood pressure at home, using it at least monthly.
Consult your doctor regularly. If you have a history of HDP, this means you should visit your doctor at least once a year to assess your cardiovascular risk. HDP is considered a risk enhancer and will be factored into your assessment, Quesada says.
Despite her tragic experience, Cantu knew she wanted more children. But she made sure her next pregnancy was different.
Cantu learned as much as she could about preeclampsia. She joined the nonprofit EndPreclampsia, a global support organization for patients with HDP. She read, researched and networked with other women with similar experiences.
When a second pregnancy was confirmed, Cantu’s sister sent her a blood pressure monitor. Cantu checked her blood pressure at home, twice a day.
“This time I went into doctor’s appointments with a lot more knowledge,” she said. “I could ask more questions. I had more self-confidence.”
Fortunately, Cantu’s preeclampsia did not return during her second pregnancy. At the end of 2023 she gave birth to a healthy girl, now 5 months old. Big sister Amelia, 3, is now a bubbly toddler.
Cantu’s strongest advice for other Latinas is to become educated about HDP and advocate for yourself during medical visits.
“Inform yourself as best you can,” she said. “Yes, you should trust your doctor, but it should not be blind trust. Asking questions. Request testing if necessary. If something doesn’t feel right, stand up for yourself.”
