During pregnancy, the maternal cardiovascular (CV) system undergoes major haemodynamic alterations ensuring adequate placental perfusion and a healthy pregnancy course. Hypertensive disorders of pregnancy (HDP) occur in almost 10% of gestations and preeclampsia, a more severe form, in 3–4%. Women with HDP demonstrated impaired myocardial function, biventricular chamber dysfunction and adverse biventricular remodelling. Shortly after delivery, women who experienced HDP express increased risk of classic CV risk factors such as hypertension, renal disease, abnormal lipid profile, and diabetes. Within the first two decades following a HDP, women experience increased rates of heart failure, chronic hypertension, ischaemic heart and cerebral disease. The mechanism underlying the relationship between HDP in younger women and CV disease later in life could be explained by sharing pre‐pregnancy CV risk factors or due to a direct impact of HDP on the maternal CV system conferring a state of increased susceptibility to future metabolic or haemodynamic insults. Racial disparities in CV risk and social determinants of health also play an important role in their remote CV risk. Although there is general agreement that women who suffered from HDP should undertake early CV screening to allow appropriate prevention and timely treatment, a screening and intervention protocol has not been standardized due to limited available evidence. In this review, we discuss why women with hypertensive pregnancy may be disproportionately affected by heart failure with preserved ejection fraction and how cardiac remodelling during or after pregnancy may influence its development.

中文翻译：

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高血压妊娠病，一种未被充分认识的女性心力衰竭特有风险因素？


在怀孕期间，母体心血管 （CV） 系统发生重大的血流动力学改变，确保足够的胎盘灌注和健康的妊娠过程。妊娠期高血压疾病 （HDP） 发生在近 10% 的妊娠中，而子痫前期（一种更严重的形式）则发生在 3-4% 的妊娠中。HDP 女性表现出心肌功能受损、双心室功能障碍和不良双心室重塑。分娩后不久，经历 HDP 的妇女表达了高血压、肾脏疾病、血脂异常和糖尿病等典型 CV 危险因素的风险增加。在 HDP 后的前二十年内，女性心力衰竭、慢性高血压、缺血性心脏病和脑病的发病率增加。年轻女性 HDP 与晚年 CV 疾病之间关系的潜在机制可以通过共享孕前 CV 危险因素来解释，或者由于 HDP 对母体 CV 系统的直接影响，使对未来代谢或血流动力学损伤的易感性增加。CV 风险和健康的社会决定因素的种族差异在他们的远程 CV 风险中也起着重要作用。尽管人们普遍认为患有 HDP 的女性应该进行早期 CV 筛查，以便进行适当的预防和及时治疗，但由于可用证据有限，筛查和干预方案尚未标准化。在本综述中，我们讨论了为什么高血压妊娠女性可能不成比例地受到射血分数保留的心力衰竭的影响，以及怀孕期间或怀孕后的心脏重塑如何影响其发展。