Pregnancy is a time of joy and anticipation, but for some women, it can also be a period of heightened health risks, particularly when it comes to hypertension. What many don’t realize is that high blood pressure during pregnancy doesn’t just affect the nine months of gestation—it can cast a long shadow over a woman’s cardiovascular health for years to come. But here’s where it gets controversial: while most pregnancies with hypertension end with healthy babies, the long-term risks to the mother’s heart health are often overlooked. And this is the part most people miss: the severity of hypertension during pregnancy directly correlates with the risk of serious cardiovascular issues later in life.
Research unveiled at the American Heart Association’s 2025 Scientific Sessions in New Orleans shed new light on this critical issue. The study revealed that women with hypertensive disorders of pregnancy (HDP) face incrementally higher risks of stroke, heart failure, coronary artery disease, and even death—risks that escalate with the severity of their condition. This underscores the urgent need for greater awareness and proactive cardiovascular risk management strategies for these women. For instance, a woman with severe preeclampsia might face a significantly higher risk of heart disease decades after giving birth, a connection that demands closer attention from healthcare providers.
Hypertensive disorders of pregnancy fall into four main categories: chronic hypertension, preeclampsia-eclampsia, preeclampsia superimposed on chronic hypertension, and gestational hypertension. While most women with HDP deliver healthy babies without immediate complications, the long-term implications for both mother and child can be alarming. High blood pressure during pregnancy can damage the mother’s kidneys and other organs, lead to preterm birth, and result in low birth weight. In severe cases, such as preeclampsia, both mother and baby’s lives can be at risk. But the story doesn’t end there—HDP is also linked to accelerated cardiovascular aging and a higher incidence of conditions like valvular heart disease, aortic stenosis, and mitral regurgitation, particularly in middle-aged women.
But here’s the million-dollar question: does the severity of HDP truly dictate the extent of long-term cardiovascular risk? A groundbreaking study by Intermountain Health aimed to answer this by analyzing 157,606 postpartum women with varying degrees of HDP severity, from gestational hypertension to eclampsia. The findings were striking: women with HDP had significantly more cardiovascular risk factors, including higher body mass index, smoking, diabetes, and lower socioeconomic status. Moreover, the risk of adverse outcomes like stroke, heart failure, and death increased proportionally with the severity of HDP, with eclampsia posing the greatest threat.
‘Any form of hypertension during pregnancy is a red flag for long-term cardiovascular health,’ emphasized Kismet Rasmusson, NP, lead researcher of the study. ‘This risk is especially pronounced in women with pre-existing chronic hypertension or severe HDP, such as eclampsia.’ But here’s where it gets controversial: many pregnant women are unaware of these risks, and healthcare systems often fail to prioritize long-term cardiovascular monitoring for these patients. Pharmacists, as integral members of the healthcare team, play a crucial role in educating and supporting at-risk women, ensuring they receive comprehensive care before, during, and after pregnancy.
So, what’s the takeaway? While HDP may seem like a temporary condition confined to pregnancy, its impact on a woman’s cardiovascular health can last a lifetime. The question remains: are we doing enough to identify and protect these women? And more importantly, should postpartum cardiovascular screening be mandatory for all women with a history of HDP? We’d love to hear your thoughts—share your opinions in the comments below and let’s spark a conversation that could save lives.
