Monica Cantu and her husband were overjoyed to learn they were expecting twins, a boy and a girl.
The couple couldn’t wait to meet their babies. At a doctor's appointment, Cantu learned her baby boy was measuring small. At 23 weeks, doctors noticed something wrong with the baby’s umbilical cord. Blood wasn’t flowing properly through the cord.
Doctors warned Cantu to expect the worst. But she held out hope for two healthy babies.
A couple of weeks later, Cantu felt a strange tingling and numbness in her face. She and her husband rushed to the hospital. Tests showed her liver enzymes were elevated. Cantu’s blood pressure was high at first, but a second reading was normal, she says.
When she didn’t improve after 2 days, doctors prepared Cantu for an emergency delivery. She was only 25 weeks along.
“Panic set in,” says Cantu, who lives in Katy, TX. “I thought, ‘These babies cannot come right now!’ My son was being estimated at just 12 ounces.”
Cantu’s baby girl, Amelia, was born strong and screaming, she recalls. But baby Roman entered the world quietly. He clung to life but died 2 days later.
Tests done during the ordeal revealed Cantu’s diagnosis: severe preeclampsia. High blood pressure is a defining feature of this pregnancy complication. Elevated liver enzymes and other signs of organ damage also are symptoms.
“Losing my son was devastating,” Cantu says. “I was left with so many questions. I carried so much guilt, like my body had failed me.”
A Rising Problem for Latinas
High blood pressure during pregnancy is a growing problem for expectant moms across the U.S. and especially for Latinas.
Hypertensive disorders of pregnancy (HDP), which include preeclampsia and gestational hypertension, more than doubled from 2007 to 2019 in the U.S., according to a study published in the Journal of the American Heart Association. Rates went up for all women, but Latina/Hispanic women experienced the sharpest rise, with more than 60 cases per 1,000 live births.
Even more concerning, new data link heart irregularities in older Hispanic women to high blood pressure they had years earlier while pregnant.
“There are significant changes in cardiac structure and function in Latina women who had high blood pressure during pregnancy, meaning their hearts have abnormalities,” says Odayme Quesada, MD, medical director for The Christ Hospital Women's Heart Center in Cincinnati and lead author of the study, published 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/Latina women with past pregnancies whose average age was about 60. Results revealed that prior HDP was connected with changes in how the heart contracts and relaxes, increased thickness of the heart wall, and higher rates of abnormal geometry in the heart’s left ventricle.
The study helps answer 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 6 months after giving birth, and their lifetime risk of chronic hypertension rises 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 who have HDP then go on to develop chronic high blood pressure?” she says. “Our study helps fill in the gaps.”
What Causes the Dangerous Complication?
During her pregnancy, Cantu’s blood pressure was sometimes high at prenatal visits but then would drop.
The fluctuation was explained away as “white coat syndrome,” she says. The term refers to anxiety or nervousness at doctor visits that can cause blood pressure to rise. Other symptoms she reported to doctors, such as extreme itching and headaches, were waved away as typical pregnancy signs.
At the time, Cantu says she didn’t know much about preeclampsia. She’d heard the term before but didn’t know how serious it is. None of her family members had experienced the complication.
Lack of awareness may be one reason HDP is rising faster in Latina women. Studies show Hispanic adults in the U.S. have the lowest rates of hypertension awareness and treatment compared with White, Black, and Asian adults.
Latinos are also less likely to have their hypertension under control, says Adriana Maldonado, PhD, assistant professor at the Mel and Enid Zuckerman College of Public Health at the University of Arizona.
Reasons behind poor hypertension control are complex, says Maldonado, lead author of a recent study about hypertension management among Latinos. Some top obstacles include lack of time to engage in lifestyle modifications, health insurance and financial constraints, and language barriers when interacting with health care providers. Limited access to health care services, culturally rich diets, and hesitancy to seek preventative care are also factors.
Social determinants of health largely explain the disparities, 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."
How to Lower Your Risk
Lowering your risk of developing hypertension while pregnant and taking action to control your blood pressure after pregnancy is key, Maldonado and Quesada say. Prevention tips include:
Adopt a heart-healthy diet. An eating style beneficial to your heart can decrease your hypertension risk, Maldonado says. 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. Incorporating exercise into your lifestyle is important, Quesada says. The American Heart Association recommends 150 minutes of physical activity a week.
Monitor your blood pressure. If you have a history of hypertension during pregnancy, keep a close eye on your blood pressure after delivery, Quesada advises. It’s a good idea to own your own blood pressure cuff and monitor your pressure at home, and use it at least monthly.
See your doctor regularly. A history of HDP means you should be visiting your doctor at least once a year to assess your cardiovascular risk. HDP is considered a risk enhancer and is factored into your assessment, Quesada says.
Be Your Own Advocate
Despite her tragic experience, Cantu knew she wanted more children. But she made sure her next pregnancy was different.
Cantu learned as much about preeclampsia as possible. 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 daily.
“This time around, I went into doctors’ appointments a lot more knowledgeable,” she said. “I was able to ask more questions. I had more confidence.”
Fortunately, Cantu’s preeclampsia didn’t return during her second pregnancy. In late 2023, she gave birth to a healthy baby girl, now 5 months old. Big sister Amelia, 3, is now a bubbly preschooler.
Cantu’s strongest advice for other Latinas is to become educated about HDP and to advocate for yourself at medical visits.
“Inform yourself as much as you can,” she said. “Yes, you should trust your doctor, but it should not be a blind trust. Ask questions. Request tests if necessary. If something doesn’t feel right, advocate for yourself.”
