̽��ֱ�� of Cambridge - Clare Oliver-Williams

Clare Oliver-Williams: a Public Engagement Explorer

zs332 — Tue, 07 Dec 2021 15:24:28 +0000

Since her PhD, Clare said yes to any opportunity to build her confidence and communication skills. Collaborating with art professionals and supported by an enthusiastic network, she blazed her trail to deliver to women who experienced pregnancy complications the call to action arising from her research findings.

Women who experience high blood pressure during pregnancy are more likely to develop heart disease

cjb250 — Wed, 01 Jul 2020 12:14:12 +0000

Between 1-6% of all pregnancies in Western countries are affected by high blood pressure, which usually returns to normal after giving birth. This condition is known as gestational hypertension, or pregnancy-induced hypertension. It differs from pre-eclampsia in that traces of protein are not found in the urine. Clinicians increasingly recognise that women who have had gestational hypertension are more likely to develop cardiovascular disease in later life.

However, studies of different kinds of cardiovascular disease, such as heart disease and heart failure, have found mixed results. To examine these links further, an international team of researchers conducted a systematic review and meta-analysis of 21 studies involving a total of 3.6 million women, 128,000 of who previously had gestational hypertension. This type of study is a way of combining data from all existing relevant studies, allowing researchers to compare and consolidate results from often-contradictory studies to reach more robust conclusions.

̽��ֱ��results are published in the Journal of the American Heart Association.

̽��ֱ��researchers found that women who experienced high blood pressure during their first pregnancy were at 45% higher risk of overall cardiovascular disease and 46% higher risk of coronary heart disease compared to women who did not have high blood pressure in pregnancy. Women with one or more pregnancies affected by high blood pressure were at 81% higher risk of cardiovascular disease, 83% higher risk of coronary heart disease and 77% higher risk of heart failure.

“When we looked at all the available research, the answer was clear: women who develop high blood pressure during pregnancy – even when it doesn’t develop into pre-eclampsia – are more likely to develop several different kinds of cardiovascular disease,” said senior author Dr Clare Oliver-Williams from the Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, ̽��ֱ�� of Cambridge.

̽��ֱ��study adds to growing evidence of the relationship between pregnancy and subsequent risk of cardiovascular events. Recurrent miscarriages, preterm birth, foetal growth restriction and pre-eclampsia have all previously been linked with a greater risk of heart disease.

̽��ֱ��researchers say it is not entirely clear why gestational hypertension is associated with heart disease in later life. However, they suggest it may be that high blood pressure in pregnancy causes lasting damage that contributes to cardiovascular disease. Alternatively, women who develop gestational hypertension may have a pre-existing susceptibility to cardiovascular disease that is revealed due to the large demands that pregnancy places upon women’s bodies.

Dr Oliver-Williams added: “It’s important that women know that it isn’t their fault that they developed high blood pressure in pregnancy, and developing heart disease isn’t a foregone conclusion. Women who have experienced gestational hypertension may have been dealt a tough hand, but it’s how they play those cards that matters the most. Small positive changes can really help. They can be as simple as eating more fruit and vegetables, small bouts of regular exercise and finding time to unwind, if that’s possible with kids around.”

Dr Oliver-Williams is a Junior Research Fellow at Homerton College, ̽��ֱ�� of Cambridge. ̽��ֱ��Cardiovascular Epidemiology Unit is supported by the British Heart Foundation and the Medical Research Council.

Reference
Lo, CCW & Lo, ACQ, et al. Future cardiovascular disease risk for women with gestational hypertension: a systematic review and meta-analysis. JAHA; 24 Jun 2020; DOI: 10.1161/JAHA.119.013991

Women who experience high blood pressure during pregnancy are more likely to develop heart disease and heart failure in later life, according to an international team of researchers.

When we looked at all the available research, the answer was clear: women who develop high blood pressure during pregnancy – even when it doesn’t develop into pre-eclampsia – are more likely to develop several different kinds of cardiovascular disease

Clare Oliver-Williams

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Pregnant woman

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Pregnancy losses and large numbers of children linked with increased risk of cardiovascular disease

cjb250 — Fri, 30 Nov 2018 00:36:32 +0000

Women who experience pregnancy loss and do not go on to have children are at greater risk of cardiovascular disease, such as heart disease and stroke, compared with women who have only one or two children, according to new research from the ̽��ֱ�� of Cambridge and the ̽��ֱ�� of North Carolina.

̽��ֱ��study, published today in the Journal of Women’s Health, also found that women who have five or more children are at an increased risk of cardiovascular disease in later life.

Cardiovascular disease is the leading cause of death among women in every major developed country and most emerging economies. Approximately 28,000 women die from heart attacks each year in the UK. In 2016 alone, 20,000 women died after having a stroke – a higher number that that in men.

During pregnancy, the mother’s body experiences changes during pregnancy including weight gain and accumulation of abdominal fat, higher levels of cholesterol, increased insulin resistance, and changes in the structure of the heart. Although most changes that occur during pregnancy are temporary, these changes are known to be risk factors for cardiovascular disease in the general population.

Previous studies have attempted to assess the relationship between pregnancy and childbirth on the one hand and cardiovascular disease on the other. However, due to limitations in these studies – including not taking into account breastfeeding history and grouping together women who had never been pregnant with those who had been pregnant but experienced pregnancy loss – their results have been inconclusive and sometimes contradictory.

In this new study, a team of researchers in the US and the UK analysed data from more than 8,500 White and African-American women, aged 45-64 years, in the US. This included health service data on cardiovascular disease over a thirty year period (1987-2016) and self-reported data on the number of pregnancies and births, and breastfeeding practices.

Within the study population, 138 women reported having experienced pregnancy loss and having no live born children. 3,108 women had one or two live born children, 3,126 had 3-4 live born children, and 1,694 had five or more live born children.

̽��ֱ��researchers found that women who experienced pregnancy loss and did not have any live born children were at 64% greater risk of both coronary heart disease and 46% greater risk of heart failure compared to women with one or two children. Women with five or more births had a 38% higher risk of having serious heart attack, regardless of how long they breastfed for.

̽��ֱ��team say that there may be several possible reasons for the link between cardiovascular risk and multiple births. Repeated pregnancies could result in long-lasting changes within the body including weight gain, especially around the waist, and increased levels of cholesterol in the blood. Also, the number of children a woman has also encompasses other factors including child-rearing, age at menopause and health conditions. Therefore, the researchers say it is unclear whether the increased risk of heart failure, coronary heart disease and heart attacks reflect the direct impact of repeated pregnancies, or the stressors associated with rearing multiple children, or both.

̽��ֱ��increased risk of coronary heart disease and heart failure found in women with prior pregnancies, but no live born children, may reflect the increased risk previously identified after a history of miscarriage. Several mechanisms have been proposed to underlie the relationship between miscarriage and coronary heart disease, including immune disorders, chronic disease and dysfunction of the endothelium (cells that line the interior of blood vessels).

“Conditions such as heart disease and stroke together are the leading cause of death in women in the developed world and it is essential that we understand why this is the case,” says Dr Clare Oliver-Williams, a Junior Research Fellow at Homerton College who works at from the Department of Public Health and Primary Care at the ̽��ֱ�� of Cambridge. “Our work suggests that there is a relation between cardiovascular disease risk and both pregnancy loss and having a large number of births.

“This study isn’t designed to stress and worry women, especially those who have experienced the distress of pregnancy loss. Instead we want to empower women with knowledge that will help them to reduce their risk.

“Most women know by the age of 40 how many children and pregnancy losses they have had, which is years before most heart attacks and strokes occur. This provides a window of opportunity to make lifestyle changes, such as exercise and diet that can help reduce the risk of cardiovascular disease.”

̽��ֱ��research was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, in the USA, and the British Heart Foundation and Homerton College, ̽��ֱ�� of Cambridge, in the UK.

Reference
Oliver-Williams, C, et al. ̽��ֱ��association between parity and subsequent cardiovascular disease in women: ̽��ֱ��Atherosclerosis Risk in Communities (ARIC) Study. ̽��ֱ��Journal of Women’s Health; 27 Nov 2018; DOI: 10.1089/jwh.2018.7161

Conditions such as heart disease and stroke together are the leading cause of death in women in the developed world and it is essential that we understand why this is the case

Clare Oliver-Williams

Geralt

Heart

Researcher profile: Dr Clare Oliver-Williams

Dr Clare Oliver-Williams first came to Cambridge in 2002 to study Natural Science as an undergraduate “and never fully left”, as she puts it. She studied her PhD here and is now a Junior Research Fellow at Homerton College.

Clare took a career break to have a family, but says she received “excellent support that made returning to academia feasible and enjoyable”. Her time now tends to be spent between her college or the Department of Public Health and Primary Care, though her research involves collaborating with researchers across the world, including in the United States and Europe, which has given her the opportunity to travel widely including to Denmark and North Carolina.

“Cambridge is a wonderful place to work for so many reasons,” she says. “It’s a hub of knowledge and activity, bringing together people from around the world. ̽��ֱ��enthusiasm so many researchers have for their work is infectious. It can make for inspiring conversations where you hear about the work and passions of others. Even when the topic of conversation is far removed from your own interests, you walk away feeling energised and motivated.”

Clare’s own research builds on her PhD, which focused on the link between miscarriages and the development of heart disease in women. She is now trying to understand the relationship between a range of female traits, such as the menopause and pregnancy, and the risk of cardiovascular disease.

“Cardiovascular disease is often thought of as a primarily male disease, but it affects large numbers of women as well,” she says. “Women undergo unique experiences in their reproductive life which may affect their risk of cardiovascular disease. I want to further our understanding of what these experiences are, and what they mean for the long-term health of women.”

Clare says she has already had her own, “tiny 15 minutes of fame” when at a British Cardiovascular Society conference, where her work led to a surprising amount of media attention, including being interviewed on live radio, being recorded for a podcast and responding to lots of email queries. It also helped her get noticed by her fellow conference attendees.

“To top it all off, I ended up winning a prize at the hackathon, an event devoted to developing solutions to clinical problems. As the announcement of the winners was late, my team mate and I ended up with my children alongside us when we accepted the award on stage!”

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