Inova experts highlight critical connections between pregnancy and heart health in preeminent international medical journal
Three-part series in The Lancet examines cardiovascular risk before, during and after pregnancy as a window into women’s lifelong heart health
FALLS CHURCH, Va. – Pregnancy can provide an important window into a woman’s cardiovascular health, revealing previously unrecognized heart disease and identifying women at increased risk for cardiovascular disease later in life. A new three-part series published in The Lancet, one of the world’s leading medical journals, and The Lancet Obstetrics, Gynaecology & Women’s Health examines cardiovascular risk across a woman’s lifespan, highlighting pregnancy and the perinatal period – from preconception through pregnancy and postpartum – as critical opportunities for risk assessment and prevention– and calls for a more integrated approach to women’s cardiovascular care.
Garima Sharma, MD, Martha Schar Chair of Women’s Cardiovascular Health and Director of Preventive Cardiology and Women’s Cardiovascular Health at Inova Schar Heart and Vascular, was a lead author of the series. Dr. Sharma also presented the introduction to the series at the 2026 European Society of Cardiology Congress in Amsterdam on Aug. 30.
Cardiovascular disease remains one of the leading causes of maternal mortality worldwide and a major driver of long-term morbidity. Yet, cardiovascular complications related to pregnancy are often underrecognized and inconsistently managed across healthcare settings. The series examines the burden of common cardiovascular diseases during pregnancy and the connection between adverse pregnancy outcomes and cardiovascular disease later in life.
“We have an opportunity to change the trajectory of women’s health,” said Dr. Sharma. “The cardiovascular changes that occur during pregnancy can reveal heart disease that was previously unrecognized, while complications such as hypertension, preeclampsia, gestational diabetes and preterm birth can signal increased cardiovascular risk later in life. Pregnancy is a unique window into a woman’s cardiovascular health, and by identifying risk earlier, we can ensure that cardiovascular care does not end when pregnancy ends.”
The three papers examine different stages of this continuum:
Cardiovascular disease during pregnancy. Tiffany Brazile, MD, Director of Exercise and Cardiometabolic Health at Inova Schar Heart and Vascular, is the first author of the series’ first paper, which examines how the heart and circulatory system adapt during pregnancy, the impact of heart disease on pregnant women around the world, and the potential risks to mothers and babies. The authors emphasize the importance of multidisciplinary pregnancy heart teams, or cardio-obstetrics teams, as well as preconception counseling, individualized cardiovascular risk assessment, genetic counseling, medication review and coordinated planning for delivery.
Hypertensive disorders of pregnancy. Antonio Saad, MD, Director of the Perinatal Research and Unit Director of the Maternal Fetal Medicine Fellowship at Inova Schar Heart and Vascular, is a contributing author to the second paper, which focuses on gestational hypertension, preeclampsia and other hypertensive disorders of pregnancy. These conditions affect an estimated 5–10% of pregnancies worldwide and are a leading cause of maternal and fetal illness and death. The authors emphasize that preeclampsia is a complex placental and cardiovascular disease and highlight the need for earlier detection and more personalized approaches to care across all hypertensive disorders of pregnancy. They also call for continued research and collaboration to advance risk prediction, prevention and treatment, as well as innovative strategies to support women after pregnancy, when the effects of these conditions can persist and increase long-term cardiovascular risk.
Adverse pregnancy outcomes and future cardiovascular disease. The third paper, co-authored by Dr. Sharma, examines the long-term cardiovascular implications of adverse pregnancy outcomes, including hypertensive disorders of pregnancy, gestational diabetes and preterm birth. These outcomes can identify women who are at substantially higher risk of cardiovascular morbidity and mortality later in life. The authors recommend that pregnancy history be incorporated into cardiovascular risk assessment and communicated beyond obstetric care to support long-term prevention and surveillance.
“These three papers tell one important story: pregnancy is not simply a nine-month event or a moment in time. It is an opportunity to understand a woman’s cardiovascular health across her lifetime,” Dr. Sharma. “We need to recognize cardiovascular risk before pregnancy, provide coordinated care when complications arise, and make sure that women who experience an adverse pregnancy outcome receive appropriate cardiovascular follow-up care long after delivery. This is an important shift from treating pregnancy complications as isolated events and instead using them as an opportunity for prevention.”
The series reflects an approach that is increasingly central to women’s cardiovascular care at Inova, where cardiology, maternal-fetal medicine, obstetrics and other specialists work together to care for women with cardiovascular conditions before, during and after pregnancy.
At Inova, this multidisciplinary approach helps women with known cardiovascular disease understand the risks associated with pregnancy and helps identify and manage cardiovascular conditions that may emerge during pregnancy. It also creates an opportunity to connect women who experience pregnancy complications with appropriate cardiovascular care after delivery, when early intervention may help reduce their long-term risk.
“The work described in this series aligns closely with what we are advancing at Inova,” said Dr. Sharma. “Our goal is not only to safely care for a woman through a high-risk pregnancy, but to use pregnancy as an opportunity to identify cardiovascular risk, connect her with the right specialists and help protect her heart health for decades to come. That requires us to think beyond delivery and care for women across the life course.”
Together, the three papers call for more integrated and equitable cardiovascular care across the reproductive life course. By recognizing pregnancy-related complications as potential early indicators of cardiovascular risk, clinicians have an opportunity to identify women at risk earlier, improve maternal and fetal outcomes and ultimately reduce the burden of cardiovascular disease among women.
###
About Inova
We are Inova, Northern Virginia and the Washington, DC metropolitan area’s leading nonprofit healthcare provider. With expertise and compassion, we partner with our patients to help them stay healthy. We treat illness, heal injury and look at a patient’s whole health to help them flourish. Through our expansive network of hospitals, primary and specialty care practices, emergency and urgent care centers, and outpatient services, Inova provides care for more than 1 million unique patients every year. Total patient visits exceed 4 million annually, demonstrating our ability to deliver the best clinical care and ensuring a seamless experience for all who rely on us for their healthcare needs.
Consistently ranked and recognized as a national healthcare leader in safety, quality, and patient experience, Inova’s world-class care is made possible by the strength and breadth of our network, our 26,000 team members, our technology, and our innovation. Using objective measures of patient experience, clinical outcomes, and safety, Modern Healthcare ranked Inova #3 in the nation among large health systems. Inova was also named the 2025 Health System of the Year by Press Ganey, recognizing our excellence in patient care, team member engagement, and commitment to continuous improvement.
Inova is home to Northern Virginia’s only Level 1 Trauma Center and Level 4 Neonatal Intensive Care Unit and provides high-quality healthcare to each person in every community we are privileged to serve – regardless of ability to pay – every day of their life. More information about Inova can be found at Inova.org.