EXPLAINER: WHY Pregnancy Complications Can Increase Your Heart Disease Risk Later

Pregnancy doesn’t just shape your body in the moment – it can offer important clues about your long-term health. Conditions like pre-eclampsia, gestational hypertension and gestational diabetes may resolve after birth, but they can signal a higher risk of heart disease later in life.

February is Women’s Heart Health Awareness Month, and at Raemini we’ve been taking a closer look at how pregnancy complications can influence health well beyond those early newborn days. This isn’t about causing alarm. It’s about understanding the facts so we can feel informed, prepared and empowered.

To help us unpack what this means in real terms, we spoke to Dr Jasmin Malek, Consultant in Family Medicine with a focus on Women’s Health, about why pregnancy can act as an early warning sign for cardiovascular disease – and what every woman should be paying attention to.

Pregnancy complications as an Early Warning Sign for Heart Health

When I speak to women about heart health, many are surprised to learn that pregnancy can act as an early “stress test” for the cardiovascular system. Conditions such as pre eclampsia, gestational hypertension, and gestational diabetes are not just pregnancy-related events, they are important predictors of future cardiovascular disease.

I know this not only as a doctor, but as a woman who experienced pre-eclampsia in my first pregnancy.

My blood pressure remained elevated for three to four months postpartum and required medication. That experience reinforced what I discuss daily in clinic: when blood pressure creeps up, it is often the first sign that the heart and blood vessels are under strain.

The importance of screening

Pregnancy complications such as pre-eclampsia occur because of abnormal placental development and increased vascular resistance, leading to inflammation and endothelial dysfunction. This process can “unmask” an underlying predisposition to high blood pressure, insulin resistance, and metabolic dysfunction. In clinic, when I see a woman with a history of pre-eclampsia or gestational hypertension, I am proactive about screening.

We assess for insulin resistance, hypercholesterolaemia, diabetes, and kidney function because cardiovascular disease does not happen overnight; it develops silently over years.

Monitoring blood pressure properly is crucial. A single reading in clinic can vary significantly. A 24-hour ambulatory blood pressure monitor is a far better screening tool as it gives us the true average during day and night. Alternatively, you can monitor at home: check your blood pressure three times a day for five days and calculate the average.

Ideally, we aim for around 120/80 mmHg. If systolic readings begin creeping above 130–135 mmHg consistently, that is a signal that intervention is needed.

The good news is that early action makes a profound difference

A low-salt diet alone can reduce blood pressure by a few points. Weight loss, regular cardiovascular and resistance exercise, smoking cessation, reducing alcohol intake, and prioritising 7–8 hours of quality sleep are all powerful tools. Stress reduction is equally important - meditation, yoga, Pilates, and breathwork all support the parasympathetic nervous system and help regulate vascular tone. Pregnancy complications are not a life sentence for heart disease, but they are a warning sign  and a powerful opportunity to act early.

If you would like to learn more about assessing your cardiovascular risk after pregnancy, Dr Jasmin Malek can be found at Healthbay Clinic.

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