Type 2 diabetes – Gestational diabetes increases the risk of coronary artery disease in black women

Global Courant

Pregnancy complications, particularly gestational diabetes and preeclampsia, are known to increase the risk of coronary artery disease, a condition to which black women are particularly susceptible. Researchers at the Medical University of South Carolina in the United States compared black women with a history of either…

• gestational diabetes (148 women),
• preeclampsia (137 participants), or
• premature birth (154 women),

with 445 black women who had normal healthy pregnancies. Their results were reported in July 2019 in the journal Circulation and cardiovascular imaging.

In coronary artery disease, the arteries that supply fresh blood to the heart muscle become clogged with plaque, which consists mainly of cholesterol. Women with any of the complications studied were more likely to have blocked coronary arteries than women without such problems. Women with a history of gestational diabetes had more than three times the risk of coronary artery disease as women without pregnancy complications. The other pregnancy complications were associated with a slightly increased risk of coronary heart disease.

Preventing gestational diabetes consists of…

• normalizing body weight before conception,
• healthy eating with lots of fruits and vegetables,
• gaining only the recommended amount, and
• exercise regularly.

Coronary artery disease can exist without any signs or symptoms. Often the disease is discovered when the person is at increased risk for the problem. They are then examined with computed tomographic angiography, which is similar to an X-ray that takes images of the heart.

Signs and symptoms of the disease are…

• pain, often described as a feeling of heaviness or tightness in the chest, back, jaw, arms, shoulders, or upper abdomen,
• dizziness,
• weakness or tiredness,
• nausea and vomiting,
• the perception of indigestion or heartburn,
• shortness of breath,
• sweating or anxiety, and
• a fast heartbeat, palpitations and
• the heart skips

When coronary artery disease is diagnosed, patients are advised…

• to normalize their weight if necessary,
• follow a diet low in solid fats and high in fruits and vegetables,
• quit smoking,
• exercise as prescribed,
• lower the stress levels in their lives, and to
• avoid drinking excess alcohol.

Medications include…

• cholesterol-lowering drugs to prevent arteries from developing more plaque,
• aspirin to prevent the formation of blood clots in the arteries,
• beta blockers to put less stress on the heart muscle,
• calcium channel blockers to relax the walls of blood vessels,
• Ranolazine, an anti-anginal medication, improves blood flow to the heart, and
• Nitroglycerin belongs to a class of drugs known as nitrates and is given to help open the coronary arteries and improve blood flow to the heart.
• Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) lower blood pressure.

Type 2 diabetes – Gestational diabetes increases the risk of coronary artery disease in black women

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