Preeclampsia (PE) affects 2–4% of all pregnancies worldwide and is associated with significant maternal and fetal morbidity and mortality[1]. The global incidence of hypertensive disorders of pregnancy (HDP) continues to increase, particularly in middle and high-income countries where prevalence of obesity, average age of pregnant women, and in vitro fertilisation is rising[2], [3]. It is known that women with PE are at increased risk of later-life cardiovascular disease (CVD)[4]. CVD is the leading cause of mortality in women worldwide[5]. Pregnancy has often been referred to as a ‘window to future health’[2] and for most women, PE is often their first major health event[6]. While current research efforts are focussed on early detection, prevention and treatment of PE[7], there is an emerging need to focus on prevention of long-term cardiovascular sequalae in those who have had PE in the past.

Current guidelines recommend regular monitoring of risk factors and general CVD risk-reduction strategies, such as smoking cessation and maintaining a healthy lifestyle[8], [9], [10]. However, all guidelines differ with respect to timing and frequency of monitoring. There is no consensus on an optimal screening strategy, nor a specific risk-reduction approach in those with a history of PE.

While three previous systematic reviews have explored postpartum hypertension (HTN) management[11] and interventions to reduce long-term CVD in women after hypertensive disorders of pregnancy[12], [13], these differed considerably with respect to inclusion criteria and scope, and as such the impact of interventions to prevent CVD in this population remains unclear. Further research is required.

The aim of this review was to systematically assess all interventions which have been trialled in women with a history of PE to reduce risk of long-term CVD.