Impact of cardiovascular disease in the obstetric population

Pregnancy triggers major cardiovascular adaptations to meet the demands of the growing fetus. While these changes are well tolerated in healthy individuals, they can reveal or exacerbate underlying cardiovascular disease. This mini-literature review explores the impact of chronic hypertension and obesity on cardiovascular physiology during and after pregnancy. Both conditions heighten the risk of complications such as heart failure, hypertensive disorders, and long-term cardiovascular disease. Chronic hypertension contributes to structural heart changes and impairs the heart's ability to manage increased volume demands. Obesity promotes inflammation, insulin resistance, and cardiac remodeling, further straining the cardiovascular system. Together, these comorbidities amplify the hemodynamic burden of pregnancy and increase the likelihood of adverse outcomes. Despite these risks, many patients do not receive adequate cardiovascular monitoring or postpartum follow-up. This review highlights the need for early risk assessment, individualized management, and multidisciplinary care to optimize maternal and fetal outcomes. Pregnancy offers a unique opportunity to identify and address cardiovascular risk, with benefits that extend well beyond the perinatal period.NEW & NOTEWORTHY Pregnancy induces substantial cardiovascular adaptations that may unmask or exacerbate underlying disease. This review highlights how chronic hypertension and obesity interact with pregnancy-related hemodynamic changes to increase cardiovascular risk. It identifies pregnancy as a critical window for early cardiovascular risk stratification and intervention.