Black women who experience high blood pressure disorders during pregnancy face significantly elevated risks for heart disease and stroke later in life, with research showing they have twice the stroke risk of white women and a threefold increase in future hypertension. These complications, including preeclampsia, are not merely pregnancy-related concerns but early warning signs of long-term cardiovascular problems that require careful monitoring and support from healthcare providers and family members .

Why Do Black Women Face Higher Cardiovascular Risks During Pregnancy?

Black women experience disproportionately higher rates of hypertensive disorders of pregnancy, a category that includes conditions like preeclampsia where blood pressure rises dangerously around the 20th week of pregnancy . The disparities extend beyond individual health choices. According to research cited by experts, the underlying causes relate to systemic factors such as "where people live, work, learn and have everyday lives," along with access to adequate healthcare and nutritious foods .

The consequences are severe. Pregnant Black women have twice the stroke risk of their white counterparts, even after adjusting for socioeconomic factors, and blood pressure-related disorders during pregnancy account for at least 4% to 6% of maternal deaths in the United States . Black women also face significantly higher rates of death due to pregnancy-related complications overall. For some women, the stakes become deeply personal. One nurse scientist watched her older sister experience two eclamptic seizures, a life-threatening complication of uncontrolled blood pressure, while pregnant with twins, an experience that inspired her to dedicate her career to maternal cardiovascular health .

"This is extraordinarily important for Black women," said Dr. Rachel M. Bond, a cardiologist and system director of women's heart health at Dignity Health in Chandler, Arizona.

Dr. Rachel M. Bond, Cardiologist and System Director of Women's Heart Health at Dignity Health

How to Protect Your Heart Health Before, During, and After Pregnancy

• Before Pregnancy: Know your baseline blood pressure and cholesterol numbers, aim for a healthy weight, and engage in regular exercise, maintain a balanced diet, and quit smoking if applicable. Preconception counseling can identify and address cardiovascular risk factors early, and women with a history of high blood pressure may need to transition to medications that are safer during pregnancy. Ask about family history, especially any relatives who experienced preeclampsia, since having a relative with this condition increases your own risk .
• During Pregnancy: Attend every prenatal visit and have your blood pressure checked at each appointment, since pregnancy acts as a "stress test" for the cardiovascular system due to increased heart rate and blood volume. Women in high-risk categories should monitor blood pressure at home using validated devices, paying attention to details like the time of day, positioning, and sodium intake that affect accuracy .
• After Pregnancy: Continue tracking your blood pressure regularly, as high blood pressure in the weeks after delivery is a common reason for hospital readmission. If you experienced preeclampsia, understand that your risk of developing high blood pressure outside of pregnancy could be three times higher, and maintain contact with your primary care physician or cardiologist even after your OB/GYN care ends around six weeks postpartum .

Pregnancy is often described as a stress test for the cardiovascular system. The increased demands on the heart during this time can reveal vulnerabilities that persist long after delivery.

"Healthy pregnancies often begin before conception," explained Dr. Rachel M. Bond. "Preconception counseling can play a critical role in identifying and addressing risk early."

Dr. Rachel M. Bond, Cardiologist and System Director of Women's Heart Health at Dignity Health

What Warning Signs Should You Watch For During Pregnancy?

High blood pressure often produces no symptoms, making regular monitoring essential. However, preeclampsia sometimes does cause noticeable signs that warrant immediate attention. Women should be alert to headaches, vision changes, shortness of breath, and excessive swelling in the legs and feet . The challenge is distinguishing these from normal pregnancy symptoms, which can feel overwhelming.

"Sometimes it is hard to distinguish these from normal pregnancy symptoms, but listening to your body and not blowing off these symptoms is important," noted Dr. Curisa Tucker, a nurse scientist and assistant professor of nursing science at the University of South Carolina College of Nursing.

Dr. Curisa Tucker, Nurse Scientist and Assistant Professor of Nursing Science at University of South Carolina College of Nursing

While some swelling is routine during pregnancy, doctors become concerned about swelling that doesn't improve when you elevate your legs. Pain in the upper right side of the abdomen may indicate liver involvement and requires immediate medical attention . More than half of pregnancy-related deaths occur between one week and one year after birth, making the postpartum period a critical time for continued vigilance .

Why Does the Postpartum Period Matter So Much for Heart Health?

The cardiovascular effects of pregnancy complications don't end when the baby arrives. Research shows that women who experience preeclampsia face a threefold increase in their risk of developing high blood pressure later in life, and studies have linked hypertensive disorders during pregnancy to heart problems decades later . Additionally, a mother's blood pressure complications during pregnancy may affect the health of her offspring years later as well .

The transition from obstetric care to primary care is crucial but often overlooked. Obstetric providers typically end their care around six weeks after delivery, yet blood pressure can spike during this exact window.

"Understanding what that postpartum period looks like and long-term treatment really can help to mitigate or decrease the risks of having any future cardiac events," said Dr. Rachel M. Bond.

Dr. Rachel M. Bond, Cardiologist and System Director of Women's Heart Health at Dignity Health

New mothers also face additional stress that can elevate blood pressure. Research published in the journal Hypertension found that women who experience pregnancy complications, including hypertensive disorders, may be vulnerable to persistently higher stress levels in addition to being at higher risk for future high blood pressure . Sleep deprivation, a universal challenge for new parents, further compounds cardiovascular strain since adequate sleep is essential for heart health .

How Can Family Members and Healthcare Systems Support New Mothers?

Postpartum cardiovascular health requires a community approach. Family members can play a critical role by helping ensure a new mother attends postpartum medical visits, assisting with blood pressure monitoring, and creating space for her to prioritize rest and maintain healthy habits . Single mothers should ask whether their delivery hospitals offer support programs, such as collectives that connect women with networks of doulas, nonmedical experts who support women through labor, delivery, and the postpartum period .

Healthcare providers must also ensure proper handoffs between obstetric and cardiovascular care. The American Heart Association has published scientific statements and created educational materials specifically addressing maternal health and postpartum cardiovascular risk, emphasizing that blood pressure monitoring and management should continue well beyond the traditional six-week postpartum visit . For Black women in particular, these conversations and support systems are not optional extras but essential components of reducing maternal mortality and long-term cardiovascular disease risk.