Physical activity and cardiovascular risk factors after hypertensive pregnancy complications

Charlotte P Ø Ziesler; Anne Cathrine Staff; Kristina Klepp; Meryam Sugulle; Kjartan Moe

doi:10.1016/j.preghy.2026.101466

Physical activity and cardiovascular risk factors after hypertensive pregnancy complications

Pregnancy Hypertens. 2026 Apr 3:44:101466. doi: 10.1016/j.preghy.2026.101466. Online ahead of print.

Authors

Charlotte P Ø Ziesler¹, Anne Cathrine Staff², Kristina Klepp³, Meryam Sugulle⁴, Kjartan Moe⁵

Affiliations

¹ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Postbox 1171 Blindern, 0318 Oslo, Norway; Division of Gynaecology and Obstetrics, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway. Electronic address: c.p.o.ziesler@studmed.uio.no.
² Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Postbox 1171 Blindern, 0318 Oslo, Norway; Division of Gynaecology and Obstetrics, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway. Electronic address: UXNNAF@ous-hf.no.
³ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Postbox 1171 Blindern, 0318 Oslo, Norway; Division of Gynaecology and Obstetrics, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway; Norwegian Research Centre for Women's Health, Oslo University Hospital, Oslo, Norway.
⁴ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Postbox 1171 Blindern, 0318 Oslo, Norway; Division of Gynaecology and Obstetrics, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway.
⁵ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Postbox 1171 Blindern, 0318 Oslo, Norway; Division of Gynaecology and Obstetrics, Oslo University Hospital, Kirkeveien 166, 0450 Oslo, Norway; Department of Obstetrics and Gynaecology, Baerum Hospital, Vestre Viken Hospital Trust, Drammen, Sogneprest Munthe-Kaas vei 100, 1346 Gjettum, Norway. Electronic address: kjartan.moe@vestreviken.no.

PMID: 41935451
DOI: 10.1016/j.preghy.2026.101466

Abstract

Objectives: Women with hypertensive disorders of pregnancy (HDP) have an increased risk of future cardiovascular disease (CVD). Physical activity (PA) improves several CVD risk factors. We therefore wanted to assess how PA associates with CVD risk factors in women who have experienced HDP, compared to normotensive controls.

Study design: We examined 215 women 1-3 years after an index pregnancy (134 with HDP and 81 controls). PA was measured over 7 days by an accelerometer. Circulating lipids, blood pressure, body mass index (BMI) and vascular structure and function parameters were measured.

Main outcome measures: Linear regression analyses studied the associations between PA levels and CVD biomarkers; circulating lipids and vascular structure and function. P < 0.05 was considered statistically significant.

Results: The previous HDP group displayed a more adverse CVD risk profile compared to controls (higher BMI, blood pressure and remnant cholesterol, more frequent overweight (BMI ≥ 25 kg/m²) and higher arterial stiffness). Achieving recommended PA levels and higher levels of moderate and vigorous activity were associated with higher HDL cholesterol, lower triglycerides and lower non-HDL and remnant cholesterol in the prior HDP group, but not in the control group. More hours of moderate and vigorous activity were associated with less arterial stiffness in the control group, but not in the HDP group.

Conclusions: Women with previous HDP, and thus at an already increased CVD risk, seem to benefit from higher PA levels. Therefore, increasing PA is likely important for optimal maternal cardiovascular health after HDP.

Keywords: Cardiovascular disease; Hypertension; Hypertensive disorder of pregnancy; PREECLAMPSIA; Physical activity; Postpartum.