Hypertensive disorders of pregnancy and long-term cardiovascular health: FIGO Best Practice Advice

Hypertensive disorders of pregnancy (HDP) are the most common causes of maternal and perinatal morbidity and mortality. They are responsible for 16% of maternal deaths in high-income countries and approximately 25% in low- and middle-income countries. The impact of HDP can be lifelong as they are a recognized risk factor for future cardiovascular disease. During pregnancy, the cardiovascular system undergoes significant adaptive changes that ensure adequate uteroplacental blood flow and exchange of oxygen and nutrients to nurture and accommodate the developing fetus. Failure to achieve normal cardiovascular adaptation is associated with the development of HDP. Hemodynamic alterations in women with a history of HDP can persist for years and predispose to long-term cardiovascular morbidity and mortality. Therefore, pregnancy and the postpartum period are an opportunity to identify women with underlying, often unrecognized, cardiovascular risk factors. It is important to develop strategies with lifestyle and therapeutic interventions to reduce the risk of future cardiovascular disease in those who have a history of HDP.

Automated summary

Hypertensive disorders of pregnancy (HDP) are the leading cause of maternal and perinatal morbidity and mortality, accounting for 16% of maternal deaths in high-income countries and approximately 25% in low- and middle-income countries. HDP increases the risk of future cardiovascular disease. Failure to achieve normal cardiovascular adaptation during pregnancy is associated with the development of HDP. Women with a history of HDP may experience long-term hemodynamic alterations, predisposing them to cardiovascular morbidity and mortality. Therefore, it is crucial to identify underlying cardiovascular risk factors during pregnancy and the postpartum period and develop strategies for lifestyle and therapeutic interventions to reduce the risk of future cardiovascular disease in women with a history of HDP.