Northwestern medical student explores trends in pre-pregnancy cardiovascular health

After completing a hospital shadowing experience at while an undergraduate student at Yale University, Michael Wang knew that he wanted to pursue medicine as a career path. Now a fourth-year medical student at Northwestern University Feinberg School of Medicine, Wang is currently applying to internal medicine residency programs with a focus in primary care.

Throughout his medical school career, Wang has been involved in extracurricular activities, including co-founding the Northwestern Medical Orchestra, and has helped conduct research alongside Feinberg faculty in the Department of Preventive Medicine.

Most recently, he published research in the American Journal of Preventive Cardiology exploring trends in pre-pregnancy cardiovascular health in the U.S, and was chosen by the American Heart Association as one of the top heart disease and stroke research advances of 2021.

Read a Q&A with Wang below.

Why did you choose Feinberg?

I was "wowed" by my interview day. I recall distinctly Dr. Roopal Kundu's admissions overview of the program. I had heard plenty of them before, but I found myself nodding when she described the values of Feinberg and being really intentional with the curriculum to develop our competencies, not only in medical science, but being patient-centered, being excellent communicators and understanding how social determinants health affect our patients. I felt like that was an environment and a type of training that would be great for me.

Now looking back, I realize that the ECMH experience has been truly formative for my career interests. I’m applying into internal medicine currently and going into primary care, and it’s really because of that unique four-year clinical experience that Feinberg provides. I didn’t know how impactful it was going to be at the time that I applied to medical school, but I’m really thankful with how that worked out.

What was the motivation for your study, "Trends in prepregnancy cardiovascular health in the United States, 2011-2019"?

This study was conducted while I spent a year doing research with Dr. Sadiya Khan in the Department of Preventive Medicine between my third and fourth years. The topic that we looked at epidemiologically was the field of cardio-obstetrics in thinking about cardiovascular health before and around pregnancy and how it relates to later cardiovascular health and cardiovascular disease in both women and their offspring. This study is trying to fill a knowledge gap we have in characterizing cardiovascular health before pregnancy in the United States.

We looked at approximately the past decade of data and used a national database based on birth certificate data to characterize four health metrics: smoking, hypertension, diabetes and BMI. Ultimately, we wanted to understand the trends in ideal cardiovascular health during the pre-pregnancy period and differences related to social determinants of health, such as insurance status and the receipt of the Women, Infants, and Children program (WIC) for supplemental nutrition.

What did your team find, and how can these findings help improve patient care?

We found that the prevalence of ideal cardiovascular health before pregnancy as measured by these four metrics declined year-over-year between 2011 and 2019, both overall in the United States and among all subgroups of women, including divisions by race and ethnicity, age, insurance status and receipt of WIC. Additionally, we identified disparities along the lines of social determinants of health between racial and ethnic groups, insurance and WIC status.

The findings have opened my eyes to the importance of prevention early in the life course. The population of persons giving live birth is generally considered to be a young, healthy population, but our results emphasize the fact that the prevalence of smoking, high BMI, hypertension and diabetes are not trivial. So, it’s important to clinically focus on prevention, even among people who are aged in their twenties, thirties or forties.

What advice would you give to prospective medical students?

Find mentors who are a good fit for you because the support of great mentors has been a part of everything that I’ve accomplished and was proud of in medical school. I couldn’t imagine the type of experience I would've had without having the support in research, teaching endeavors I’ve been involved in and extracurricular activities. Finding the faculty support in your corner early, I think, helps set a medical student up for the best possible experience.

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