Advances in Kidney Disease and Health · Jul 2026
Preeclampsia and Risk of Future Hypertension in Women and Offspring
By Schiff AF, Shah S, South AM
Although a pregnancy-specific condition, preeclampsia is believed to be an indicator of higher future risk of cardiovascular morbidity and mortality in women and offspring over their life course. Factors such as diagnostic criteria and overlapping features with other hypertensive disorders of pregnancy have made it challenging to understand the precise pathophysiologic mechanisms that contribute to future cardiovascular disease for both women and offspring. Unique pathophysiological features of preeclampsia distinguish it from the other hypertensive disorders of pregnancy. Increasing preeclampsia prevalence and growing health care concerns regarding higher lifelong cardiovascular morbidity to mothers and offspring beyond pregnancy has prompted this comprehensive review consisting of (1) early-programming of hypertension and preeclampsia; (2) updated clinical and epidemiological evidence; (3) key health and population considerations; (4) clinical considerations specific to maternal-fetal medicine, neonatology, hypertension subspecialties, and primary care; and (5) key knowledge gaps to prioritize and future directions. Finally, we review the cardiovascular-kidney-metabolic framework as it relates to the hypertensive disorders of pregnancy.