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Hypertension in pregnancy: a potential window into long-term cardiovascular risk in women.

Hypertensive disorders of pregnancy affect approximately 6 ‐ 8% of pregnancies and are the second leading cause of maternal mortality in the United States. They are also a leading cause of maternal and neonatal morbidity (1). Despite the frequency of these disorders, their cause is unknown and their treatment is inadequate. Hypertension in pregnancy is a gender specific condition by definition. As with many other disorders that affect women, hypertension in pregnancy involves the overlap of the fields of internal medicine and obstetrics. Whereas most essential hypertension is managed by internists, when a pregnant woman is hypertensive, the care of the hypertension is managed primarily by obstetricians. This leads to an interesting potential duality in the focus and approach of each specialty. In general, hypertension in pregnancy has been viewed as an obstetrical disorder and has not been an area of investigation for most internists. For the obstetrician, the disorder is one of pregnancy itself, and the focus is on the outcome of the individual pregnancy. On the other hand, for the internist an emerging focus is on the potential implications of hypertensive pregnancy for the future health of the individual woman.