Physical activity and cardiovascular risk factors after hypertensive pregnancy complications

• Prior hypertensive pregnancies associated with adverse cardiovascular profile. • Physical activity (PA) associated with better lipid profile after such complications. • After normotensive pregnancies, PA associated with a lower augmentation index. 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. 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. 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. 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/m 2 ) 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. 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.