Does having pre-eclampsia in the past increase my risk of heart disease later?

Pre-eclampsia is a pregnancy complication marked by high blood pressure and signs of organ damage. Research shows that having pre-eclampsia does increase your risk of developing heart disease later in life. This risk appears to be tied to lasting changes in your blood vessels, even if your blood pressure returns to normal after delivery. The good news is that knowing this risk gives you and your doctor a chance to take early steps to protect your heart.

What the research says

A large meta-analysis (a study combining results from many studies) found that women with a history of pre-eclampsia have higher levels of subclinical atherosclerosis — early, symptom-free buildup of plaque in arteries — compared to women who never had pre-eclampsia ³. This difference was seen not only during pregnancy but also up to 12 months after birth and beyond ³. Subclinical atherosclerosis is a known predictor of future heart attacks and strokes.

Another study specifically looked at women who had a heart procedure (stent placement) and found that about 1 in 4 had a history of pregnancy complications like pre-eclampsia ⁷. However, doctors often did not document these pregnancy-related risk factors in the women's medical records, suggesting that this important clue to heart disease risk is frequently overlooked ⁷.

While pre-eclampsia itself is a direct risk factor, it is also linked to other conditions that raise heart disease risk. For example, women with pre-eclampsia are more likely to develop gestational diabetes, and both conditions share underlying issues like inflammation and blood vessel problems ¹⁴. The connection is strong enough that experts recommend women with a history of pre-eclampsia be screened for cardiovascular disease risk factors, though uniform guidelines are still lacking ³.

What to ask your doctor

• Given my history of pre-eclampsia, should I have my blood pressure and cholesterol checked more often?
• Would a test for early signs of heart disease, like a coronary artery calcium scan or carotid ultrasound, be helpful for me?
• What lifestyle changes (diet, exercise, not smoking) are most important to lower my heart disease risk after pre-eclampsia?
• Should I see a cardiologist or a specialist in women's heart health for a full risk assessment?
• Are there any medications, such as low-dose aspirin or statins, that might be recommended for me based on my pregnancy history?