The risk of developing hypertension and cardiovascular disease (CVD) significantly increases for patients who experience gestational hypertension, preeclampsia, or other hypertensive disorders of pregnancy (HDP). Current strategies to reduce the future risk of developing chronic hypertension, heart disease, and stroke include lifestyle changes like healthy eating and regular exercise. However, patients often hesitate to implement these changes because they do not fully understand the risks to their long-term heart health.

Researchers developed a survey to evaluate postpartum patients' understanding of their CVD (heart disease) risk and to explore their opinions on how to reduce that risk. The results suggest that at the time of their hospital discharge, many patients are unaware of the long-term impact on their heart health or how they can live a heart-healthy lifestyle.

In this study, 203 patients at the Birth Center at Froedtert Hospital, a large academic medical center in Milwaukee, Wisconsin, completed the survey. The survey was completed during postpartum days 1-3 before hospital discharge. The mean age of the group was 31.1 years. 73.3% self-identified as White, 20.3% as Black, 9.4% as Hispanic or Latino; 63.3% held a bachelor’s or graduate degree; 58.1% had commercial insurance; and 19.7% had a history of HDP. In addition, 62.1% were diagnosed with gestational hypertension and 37.9% with preeclampsia. 22.3% were taking blood pressure medication.

Most respondents felt only moderately (42%) or not at all informed (17%) about their risk of developing future hypertension or heart disease. 40.6% reported feeling well (27%) or very well (12%) informed about the future risk of CVD. Despite this, 71.4% of those who felt well or very well informed, as well as 72.1% of all respondents underestimated their future risk of heart disease to be less than or equal to 10%. However hypertensive disorders of pregnancy increase the risk of chronic hypertension by about 4x, heart disease and stroke by about 2x, and death by about 1.5x (Sukmanee, J. et al (2022))

Those with preeclampsia were more likely to accurately predict the risk compared with those with gestational hypertension, but there was no significant difference when responses were analyzed by race, ethnicity, education status, or history of HDP.

Survey respondents expressed willingness to take steps to manage their heart health by starting a daily exercise program or making changes in their diet. However, only a small number were willing to take medication to control blood pressure even if diet and exercise were not sufficient to reduce it. 27.6% preferred daily exercise, 51.3% preferred eating a healthier low-salt diet, and 21.1% preferred an antihypertensive medication. 65.4% would consider medication only if diet and exercise were unsuccessful. Those who declined blood pressure medication as second-line treatment believed that their blood pressure would normalize postpartum and wanted to avoid medication use or dependency. While 43.5% reported that healthy eating and exercising requires significant effort, 68.4% planned to make lifestyle changes to reduce their risk of hypertension and heart disease.

Take Home Message:

This study showed that many patients with high blood pressure during pregnancy recognize the immediate health risks but are unaware of its link to future risk of heart disease. While 40.6% feel somewhat informed about their risk, many underestimate their chances of developing high blood pressure or heart issues later. Once they understand the risks, they are willing to make lifestyle changes but find it challenging. Additionally, many are hesitant to take medication for high blood pressure. Future efforts to educate patients about the long-term impact of preeclampsia and gestational hypertension on heart health need to consider these patient perspectives. More research is needed on effective patient support, education, and risk prevention.

While preeclampsia survivors cannot change the fact that they experienced a hypertensive disorder of pregnancy, modifiable heart disease risk factors like blood pressure control, diet, and exercise are recommended. For more information on your health beyond pregnancy and how to reduce your future risk of heart disease and stroke, visit:

https://preeclampsia.org/heart-disease-stroke

https://preeclampsia.org/beyondpregnancy

Citation: Sunji N, Tovar N, Flynn KE, Hauspurg A, Palatnik A. Cardiovascular Disease Risk Awareness and Prevention Perspectives Following Hypertensive Disorders of Pregnancy. Hypertension. 2025 May;82(5):e102-e104. doi: 10.1161/HYPERTENSIONAHA.125.24838. Epub 2025 Apr 16. PMID: 40238906; PMCID: PMC12007699.

Link: https://pubmed.ncbi.nlm.nih.gov/40238906/

About Research Roundup

Each quarter, our team of science writers reviews the most current research studies related to hypertensive disorders of pregnancy and summarizes those studies of greatest interest and potential impact to our community, including research studies related to risk assessment, diagnosis, prevention, and treatment. Special thanks to our volunteer research team including Dr. Sig-Linda Jacobson, Dr. Jennifer Mitchell, Dr. Julie Reynolds, Amanda Yang, and Simren Gupta who make Research Roundup possible, and to our Patient Advisory Council, who reviews these materials from the patient perspective.