For women who experience preeclampsia – a pregnancy complication characterized by high blood pressure – the risk of long-term heart disease is significantly elevated. New research and growing awareness are highlighting the need for proactive cardiovascular health monitoring in these patients, even years after pregnancy.
Researchers, like Dr. Anna Stanhewicz, an associate professor at the University of Iowa, are working to understand the subtle changes that occur in women following preeclampsia, even before clinical symptoms of heart disease develop. The research that I do is really trying to understand what’s different in that window of time when these patients look clinically normal, before they have disease,
Dr. Stanhewicz explained.
Preeclampsia affects approximately one in 12 pregnancies, according to the Preeclampsia Foundation. While the condition often resolves after childbirth, the cardiovascular consequences can persist for decades. Kara Boeldt, founder of End Preeclampsia and a Quad Cities native, has become a vocal advocate for increased awareness and preventative care. She experienced severe preeclampsia during her pregnancy and now faces a cardiovascular risk profile comparable to that of a daily three-pack-a-day smoker.
One in three women die of cardiovascular disease. Two of three women die of cardiovascular disease if they’ve had a hypertensive pregnancy,
Boeldt stated, emphasizing the stark reality of the increased risk. So [we] just have this huge risk and no one is… Not many people are talking about it.
Subtle Vascular Changes and Long-Term Risk
Dr. Stanhewicz’s research reveals that even after pregnancy, blood vessel function remains negatively impacted in women who have experienced preeclampsia. Her team has observed approximately a 20% decrease in blood vessel function in these patients, a reduction she describes as measurable
, meaningful
, and quite similar to what you would see if we were measuring these responses in older adults, say, over the age of 65.
This suggests a premature aging of the cardiovascular system linked to the pregnancy complication.
While widespread clinical practice changes are still years away, progress is being made in understanding and addressing this risk. Dr. Stanhewicz and her team are exploring potential interventions, including the use of existing blood pressure medications – typically not prescribed to this patient group – to improve blood vessel function. We’ve] been able to show, actually, we can use that type of intervention to improve blood vessel function,
she noted.
Proactive Monitoring and Lifestyle Modifications
In the meantime, experts recommend that women with a history of preeclampsia prioritize proactive cardiovascular health monitoring after giving birth. This includes establishing baseline levels of cardiovascular health with their healthcare providers. Discussing pregnancy history and lifestyle habits is important, so doctors are aware of risk factors,
Dr. Stanhewicz advised. Maintaining a healthy lifestyle through proper nutrition, regular exercise, and stress management is also crucial in mitigating risk.
Boeldt’s organization, End Preeclampsia, is advocating for more open communication between patients and healthcare providers during pregnancy. She believes that even brief check-ups can be improved by providing more detailed explanations about blood pressure and urine tests, and clearly outlining potential concerns. Facilitating those conversations, ‘oh, we’re going to check your blood pressure now, and here’s why. We’re going to test your urine, and this is the result and this is great and this is what we’re looking for and here’s what would be concerning and why that would be concerning,’
Boeldt explained.
Improving Symptom Recognition
A key challenge is improving recognition of preeclampsia symptoms, which can often mimic common pregnancy discomforts like swelling, headaches, and weight gain. Boeldt emphasizes the need for specific education, not just for patients but also for their support networks. She recounted an experience where she asked her husband if her face appeared swollen, a symptom mentioned by her medical team. Her husband, attempting to reassure her, said it did not, leading her to initially dismiss the symptom. Very next day, we were driving to our very first birthing class, and I was like… ‘the midwife said this, the midwife said that, and the swelling in the face,’ his jaw dropped… [Her husband said] ‘I told you no because I didn’t want you to feel bad,’
Boeldt shared. The education has to go beyond just the patient as well to ensure support people are able to advocate for that person.
The Path Forward: Prevention and Early Intervention
While clinical practice guidelines are still evolving, both Boeldt and Dr. Stanhewicz emphasize the importance of ongoing communication with medical providers and adopting healthy habits. Dr. Stanhewicz acknowledged the difficulty of preventing disease, stating, Notice usually good clinical guidelines for treating the disease once it’s developed. It’s much harder to understand or prescribe something to prevent disease.
Her research program focuses on identifying changes at the blood vessel level to develop recommendations for preventing the progression of cardiovascular disease in women with a history of preeclampsia.
Research published in in the European Cardiology Review further supports the link between hypertensive disorders of pregnancy, including pre-eclampsia, and increased cardiovascular risk, extending beyond the postpartum period. A study presented at ’s ESC Preventive Cardiology conference showed that cardiovascular risk factors appear, on average, eight years earlier in women who experienced pre-eclampsia compared to those who did not. Experts recommend systematic risk assessment beginning at age 35 for women with a history of pre-eclampsia, repeated at least every five years.
