PCOS and Pregnancy BP: Reducing the Risk of Future Heart Disease

By Dr. Richa Agrawal in Cardiology Interventional Cardiology

Sep 18, 2025

Polycystic Ovary Syndrome (PCOS) is one of the most common hormonal conditions affecting women in reproductive age. While most people connect it mainly with fertility struggles, PCOS has much wider health impacts—especially during pregnancy. One important concern is high blood pressure (BP) in pregnancy, which can raise the chances of complications and also increase a woman’s long-term risk of heart disease. The good news: with the right care, these risks can be lowered.

Why PCOS and Pregnancy BP Are Linked to Heart Risk

Women with PCOS often have insulin resistance, excess weight around the waist, and hormonal imbalances. These factors make them more likely to develop high BP during pregnancy, such as gestational hypertension or preeclampsia.

• Pregnancy as a stress test: During pregnancy, the heart and blood vessels work harder. If there is already metabolic or vascular stress due to PCOS, complications can surface.
• Future health signal: High BP in pregnancy is not just a temporary issue. It acts as an early warning that the woman may face higher risks of hypertension, heart attack, or stroke later in life.

Key Risk Factors That Worsen the Problem

1. Excess body weight before or during pregnancy
2. Family history of hypertension or heart disease
3. Older maternal age
4. Previous pregnancy complications
5. Uncontrolled blood sugar or insulin resistance

These factors combine with PCOS to make the cardiovascular system more vulnerable.

Steps to Lower Heart Risk in Women with PCOS

1. Before Pregnancy: Build a Strong Foundation

• Aim for a healthy body weight through gradual weight loss.
• Choose a nutrient-dense diet rich in vegetables, fruits, whole grains, lean protein, and good fats.
• Stay active with at least 150 minutes of moderate exercise weekly.
• Get screened for blood sugar, cholesterol, and blood pressure before conception.

2. During Pregnancy: Careful Monitoring

• Inform your doctor about PCOS history early in pregnancy.
• Monitor blood pressure at every prenatal visit.
• Follow a balanced pregnancy diet—limit processed foods, excess salt, and sugary snacks.
• In some high-risk cases, doctors may recommend low-dose aspirin to prevent preeclampsia.
• Track weight gain and keep it within healthy limits.

3. After Delivery: Don’t Stop Caring

• Continue blood pressure checks, especially in the first year postpartum.
• Maintain healthy eating and exercise habits while adjusting to new motherhood.
• Watch for warning signs like frequent headaches, chest discomfort, or unusual fatigue.
• Schedule long-term follow-ups with your gynecologist or cardiologist to monitor heart health.

Lifestyle Tips for Lifelong Protection

• Eat smart: Focus on whole foods and cut down on fried, sugary, and salty items.
• Move daily: Even simple activities like walking, yoga, or light strength training protect the heart.
• Manage stress: Meditation, breathing exercises, and enough sleep help regulate hormones.
• Avoid smoking and limit alcohol: Both increase cardiovascular risks.

Conclusion

PCOS combined with pregnancy complications like high blood pressure should not be seen as a short-term concern. Instead, it’s a valuable signal to take heart health seriously. By preparing before pregnancy, monitoring carefully during it, and continuing preventive habits afterward, women with PCOS can lower their long-term risk of cardiovascular disease.

Every step—whether it’s eating right, staying active, or having regular medical check-ups—adds up to a healthier future for both mother and child.

FAQs on PCOS, Pregnancy, and Heart Risk

Q1. Does PCOS always lead to high blood pressure in pregnancy?
No, not always. But women with PCOS have a higher risk compared to women without PCOS. Risk increases further with obesity, age, or family history of hypertension.

Q2. Can lifestyle changes really reduce pregnancy-related BP complications?
Yes. Studies show that even a small weight loss before pregnancy, a balanced diet, and regular exercise can lower risks of gestational hypertension and preeclampsia.

Q3. Is medication like aspirin safe for women with PCOS during pregnancy?
Low-dose aspirin may be recommended for high-risk women, but only under a doctor’s supervision. It is not for everyone, so medical advice is essential.

Q4. After pregnancy, should women with PCOS still monitor their heart health?
Absolutely. Women who develop high BP during pregnancy remain at greater risk of cardiovascular disease later. Regular follow-ups help in early detection and prevention.

Q5. Can PCOS itself cause heart disease?
PCOS doesn’t directly cause heart disease, but the hormonal and metabolic changes linked to it—such as insulin resistance, obesity, and high cholesterol—raise the risk.