A groundbreaking investigation conducted by researchers at Intermountain Health has unveiled a critical link between hypertensive disorders of pregnancy (HDP) and a substantially heightened risk of severe cardiovascular events within five years postpartum. This extensive study sheds new light on the profound and lasting impact that hypertension during pregnancy exerts on maternal cardiovascular health, emphasizing the urgent need for improved screening, intervention, and multidisciplinary care strategies.
The research, encompassing data from over 218,000 live births among more than 157,000 patients across 22 hospitals within the Intermountain Health system, provides one of the most comprehensive analyses to date on the correlation between pregnancy-related hypertension and subsequent cardiovascular complications. By analyzing electronic medical records spanning seven years, from 2017 to 2024, the team systematically categorized patients based on the presence of chronic hypertension and HDP subtypes, including gestational hypertension, preeclampsia, and eclampsia. These conditions were then rigorously linked to incidences of heart attack, stroke, heart failure, coronary artery disease, and mortality, with patient outcomes tracked for an average duration of five years following childbirth.
The study’s principal investigator, Kismet Rasmusson, NP, highlighted that any manifestation of high blood pressure during pregnancy results in a marked elevation of cardiovascular risk later in life. The findings suggest that the physiological stress imposed by hypertensive states during gestation initiates or exacerbates pathophysiological processes such as vascular inflammation, endothelial dysfunction, and myocardial strain, thereby seeding the development of chronic cardiovascular disease. This risk escalates dramatically in patients suffering from severe HDP forms, notably eclampsia, where neurological and systemic complications reflect critical cardiovascular burden.
Particularly striking is the discovery that nearly one in five patients, specifically 19.7%, received an HDP diagnosis during their pregnancy. The prevalence underscores the urgency of recognizing HDP not merely as a transient obstetrical issue but as a sentinel event foreshadowing lifelong cardiovascular vulnerability. The majority of these diagnoses occurred during the index live birth, suggesting an opportunity for early intervention in subsequent pregnancies and beyond.
Patients with HDP were also found to exhibit a clustering of traditional cardiovascular risk factors including obesity, tobacco use, type 2 diabetes mellitus, dyslipidemia, and psychosocial stressors such as depression and compromised socioeconomic status. This compounding of risk factors may potentiate the adverse cardiovascular trajectory, underscoring the necessity for holistic patient management that addresses metabolic, behavioral, and social determinants of health in addition to clinical hypertension.
Quantitatively, the risk amplifications revealed by the study are profound. Women with HDP faced a three to thirteen-fold increased risk of developing heart failure, a condition signifying compromised cardiac function with significant morbidity and mortality. Stroke risk escalated between two to seventeen times, highlighting the cerebrovascular consequences of hypertensive pregnancy disorders. The incidence of myocardial infarction rose three to seven times, while coronary artery disease followed a similar 2 to 7 times increased risk profile. Mortality risk was also significantly heightened, ranging from 1.4 to fourfold increases in women with pregnancy-associated hypertension.
This gradient of risk correlating with HDP severity provides valuable clinical insight. Women with pre-existing chronic hypertension who subsequently developed eclampsia were identified as bearing the highest cardiovascular risk, underscoring the additive and synergistic detrimental effects of layered hypertensive pathologies during pregnancy. These insights propel the notion that stratified risk assessment models incorporating HDP phenotype and severity could better inform postnatal surveillance and risk mitigation strategies.
Despite the overwhelming evidence supporting the long-term cardiovascular consequences of HDP, awareness among patients and healthcare providers remains surprisingly insufficient. Many women are not adequately counseled regarding their postpartum cardiovascular risks, nor are they routinely monitored or guided through tailored prevention plans. This gap in care represents a critical public health concern that demands urgent rectification through enhanced education and system-level interventions.
In response, Intermountain Health is pioneering an integrated clinical care framework that transcends traditional obstetrics-centric models. By incorporating expertise from primary care, cardiology, and mental health disciplines, a collaborative, multidisciplinary approach is being established to provide comprehensive support for women identified as high-risk. This model aims to bridge the current fragmentation in care delivery and implement personalized strategies that encompass preconception counseling, rigorous blood pressure management during pregnancy, and sustained cardiovascular surveillance post-delivery.
The implications of these findings extend beyond clinical practice into the realms of public health policy and maternal health advocacy. As hypertensive pregnancy disorders continue to rise globally in parallel with increasing prevalence of obesity and metabolic syndrome, addressing these risks effectively could substantially reduce maternal morbidity and mortality worldwide. Early identification and intervention may also attenuate the intergenerational transmission of cardiovascular risk, fostering healthier families and communities.
By illuminating the mechanistic pathways and clinical consequences of hypertensive pregnancy disorders, this research calls attention to a critical, yet underrecognized, contributor to women’s long-term cardiovascular health. It advocates for a paradigm shift in how pregnancy-related hypertension is perceived, managed, and integrated into broader chronic disease prevention efforts. The study, presented at the prestigious American Heart Association Scientific Sessions in 2025, represents a clarion call for the medical community to mobilize resources toward protecting women’s hearts during and long after pregnancy.
This landmark study’s contribution is not only scientific but also profoundly humanitarian, as it underscores the necessity to safeguard maternal health comprehensively. Through heightened awareness, interdisciplinary collaboration, and patient-centered care, the medical field is poised to address one of the most pressing and preventable causes of cardiovascular disease among women. The Intermountain Health research thus sets the stage for transformative advances in both maternal and cardiovascular health domains, promising improved outcomes for millions of women worldwide.
Subject of Research: People
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Image Credits: Intermountain Health
Keywords: Hypertension, Pregnancy
