Field Notes
Pregnancy Complications Contribute to Cardiovascular Risk for Overweight Women
Complications during pregnancy (or adverse pregnancy outcomes), like gestational diabetes and newly developed high blood pressure, act as nature’s stress test and may uncover an individual’s risk for heart disease later in life, according to new research published in the JACC, the flagship journal of the American College of Cardiology. The study also highlights how weight management before pregnancy may not only improve maternal health but also reduce future CVD risk.
The observational study, which tracked outcomes for women over more than 10 years, helps answer a key question: whether pregnancy complications contribute to cardiovascular risk or are just a marker for underlying risk factors that were there all along.
“Understanding the connection between adverse pregnancy outcomes and cardiovascular disease is important in the development of effective preventative strategies and determining the best timing for intervention to support long-term heart health,” says Jaclyn Borrowman, PhD, a researcher at Northwestern University and lead author of the study.
Pregnancy is often considered a “window” into future health, as complications during pregnancy can reveal underlying risks for chronic conditions, Borrowman notes.
Adverse pregnancy outcomes affect around 20% of all pregnancies in the United States and are known to increase risk of later CVD by two to four times.
For the study, researchers tracked 4,269 pregnant women across nine countries, following up on outcomes over 10 to 14 years. They looked at measurements for blood pressure, triglycerides, fasting glucose, and hemoglobin A1c, comparing participants with overweight or obesity with those who had normal BMI. Secondary outcomes included the incidence of hypertension or diabetes at the midlife follow-up.
They found that adverse pregnancy outcomes contributed significantly to the link between pre pregnancy overweight or obesity and cardiovascular risk factors in midlife. In addition, different types of complications affect different health risks. Specifically, gestational diabetes enhanced risk for higher glucose and hemoglobin A1c, while hypertensive disorders contributed to risk for high blood pressure in midlife.
Borrowman notes that, even though these pregnancy complications helped explain the link between pre pregnancy weight and heart disease risk, they didn’t account for most of the connection—other factors are also involved.
“The study highlights the significance of adverse pregnancy outcomes as a risk-enhancing factor for cardiovascular disease,” Borrowman says. “Our results also suggest that prioritizing weight management among those considering pregnancy may promote both maternal and future cardiovascular health.”
In an accompanying editorial comment, Garima Sharma, MD, director of preventive cardiology and women’s cardiovascular health at Inova Health System, says the study provides “insightful information” that could help guide screening, counseling, and management.
“The results of the study underscore the value in addressing excess adiposity in the prepregnancy and postpartum period, particularly as there are options with emerging therapies such as new antiobesity medications,” she says.
Sharma adds that the findings also highlight the need to study the safety and efficacy of these medications in pregnant and lactating women, who have historically been excluded from clinical trials.
As a follow-up, Borrowman says researchers are studying the link between early pregnancy cardiovascular health and the incidence of complications, with the goal of identifying potential interventions that could improve maternal health and reduce CVD.
— Source: American College of Cardiology
Cinnamon Could Affect Drug Metabolism in the Body
Cinnamon is one of the oldest and most commonly used spices in the world, but a new study from the National Center for Natural Products Research indicates a compound in it could interfere with some prescription medications.
In a recent study published in Food Chemistry: Molecular Sciences, researchers at the University of Mississippi Center found that cinnamaldehyde, a primary component of cinnamon, activates receptors that control the metabolic clearance of medication from the body, meaning consuming large amounts of cinnamon could reduce the effects of drugs.
"Health concerns could arise if excessive amounts of supplements are consumed without the knowledge of health care provider or prescriber of the medications," says Shabana Khan, PhD, a principal scientist in the center. "Overconsumption of supplements could lead to a rapid clearance of the prescription medicine from the body, and that could result in making the medicine less effective."
Aside from its culinary uses, cinnamon has a long history of being used in traditional medicine and can help manage blood sugar and heart health, and reduce inflammation. But how the product actually functions in the body remains unclear.
Sprinkling cinnamon on your morning coffee is unlikely to cause an issue, but using highly concentrated cinnamon as a dietary supplement might.
"Despite its vast uses, very few reports were available to describe the fate of its major component, cinnamaldehyde," Khan says. "Understanding its bioaccessibility, metabolism, and interaction with xenobiotic receptors was important to evaluate how excess intake of cinnamon would affect the prescription drugs if taken at the same time."
Not all cinnamon is equal. Cinnamon oil, which is commonly used topically as an antifungal or antibacterial and as a flavoring agent in food and drinks, presents almost no risk of herb-drug interactions, says Amar Chittiboyina, the center's associate director.
But cinnamon bark, especially Cassia cinnamon, a cheaper variety of cinnamon that originates in southern China, contains high levels of coumarin, a blood thinner, compared with other cinnamon varieties. Ground Cassia cinnamon bark is what is normally found in grocery stores.
"In contrast, true cinnamon from Sri Lanka carries a lower risk due to its reduced coumarin content," he says. "Coumarin's anticoagulant properties can be hazardous for individuals on blood thinners."
More research is needed to fully understand the role that cinnamon plays in the body and what potential herb-drug interactions may occur, says Bill Gurley, a principal scientist in the center and coauthor of the study.
"We know there's a potential for cinnamaldehyde to activate these receptors that can pose a risk for drug interactions," he says. "That's what could happen, but we won't know exactly what will happen until we do a clinical study."
Until those studies are complete, the researchers recommend that anyone interested in using cinnamon as a dietary supplement check with their doctor first.
"People who suffer from chronic diseases—like hypertension, diabetes, cancer, arthritis, asthma, obesity, HIV, AIDS, or depression—should be cautious when using cinnamon or any other supplements," Khan says. "Our best advice is to talk to a health care provider before using any supplements along with the prescription medicine.
"By definition, supplements are not meant to treat, cure, or mitigate any disease."
— Source: University of Mississippi