(Vienna, 12 May 2026) Pre-eclampsia is no longer regarded as an isolated pregnancy complication, but as a significant risk factor for subsequent cardiovascular disease. Nevertheless, blood pressure control remains the central therapeutic measure. An international study led by MedUni Vienna now shows for the first time that the current practice of using medication to lower blood pressure does not significantly influence the long-term impairment of the mother’s cardiovascular system. The results, published in the specialist journal Hypertension, thus highlight the need for new therapeutic approaches and strategies to improve the cardiovascular health of affected mothers.
A total of 238 women were included in the study, comprising 132 women with hypertensive pregnancy-related conditions (69 with so-called gestational hypertension and 63 with pre-eclampsia) and 106 healthy control subjects. The women were treated with antihypertensive medication in a clinical setting and assessed for key parameters of cardiovascular function. These include cardiac output, an indicator of the heart’s pumping capacity, and systemic vascular resistance, an important factor in cardiac workload.
The results present a nuanced picture: In cases of pregnancy-induced hypertension, antihypertensive therapy led to the desired increase in cardiac output and a reduction in vascular resistance. In pre-eclampsia, however, there was no significant improvement in these cardiovascular parameters, even though blood pressure could be lowered. The treatment therefore influences only part of the complex disease process.
Focus on blood pressure falls short
"Our study shows that hypertensive disorders of pregnancy, and pre-eclampsia in particular, should be understood as systemic diseases in which several components of cardiovascular regulation are affected," says study lead Julia Binder (Head of the Working Group on Hypertensive Disorders of Pregnancy, Department of Obstetrics and Feto-Maternal Medicine, MedUni Vienna). "Accordingly, blood pressure medication should possibly be adapted to the mother’s cardiovascular function as part of a personalised therapy – a standard treatment for everyone does not appear to be effective. Furthermore, blood pressure must be controlled more strictly than before; guidelines from recent years already call for lower target values."
Pre-eclampsia usually occurs in the second or third trimester of pregnancy, is one of the most serious complications of pregnancy and affects millions of women worldwide. The condition is characterised by high blood pressure and increased protein excretion in the urine and can be life-threatening if not treated in time. Furthermore, affected women have a significantly increased risk of developing cardiovascular diseases such as heart attacks or strokes later in life. Currently, the treatment of pre-eclampsia essentially consists of medication to lower blood pressure.
The current study highlights the need for further therapeutic strategies that go beyond mere blood pressure control. For clinical practice, this means that pre-eclampsia patients must continue to be carefully monitored even when their blood pressure is successfully controlled: "Our study results have confirmed that the cardiovascular changes associated with pre-eclampsia persist even after the baby has been born, and that they lead to a long-term increased cardiovascular risk for these patients. Targeted measures are therefore needed not only during pregnancy but also in the postpartum period to ensure long-term cardiovascular health in these women" says Julia Binder.
Publication: Hypertension
Effects of Antihypertensive Therapy on Pre- and Postnatal Maternal Hemodynamics.
Julia Binder, Pilar Palmrich, Meryam Sugulle, Erkan Kalafat, Nawa Schirwani-Hartl, Asma Khalil, Lorenz Pixner, Khaled Kantoush, Sarah Michelle, Kristin Kraeker, Nadine Haase.
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.125.26126