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HDP increases the risk of cardiovascular events later in life, but whether repeated HDP episodes confer cumulative risk remains unclear. We\u00a0aimed to assess the association between recurrent HDP and subsequent maternal coronary heart disease (CHD), stroke, and all\u2010cause mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort included women aged 12\u201349 with two or more singleton live births in South Carolina (2004\u20132016). Deliveries were evaluated for HDP (preeclampsia, eclampsia, gestational hypertension), defined by birth certificate and\/or hospitalization\/emergency department (ED) visit data. Women had recurrent, one, or no pregnancies with HDP. Outcomes were defined with hospitalization\/ED visit and death certificate data. The association of recurrent HDP with CHD, stroke, and mortality were assessed with Cox models incorporating time\u2010varying covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 163,579 women with two or more pregnancies (59.0% non\u2010Hispanic White, 32.7% non\u2010Hispanic Black, and 8.4% Hispanic), 4.8% had more than one (recurrent), one (15.2%), or no (80.0%) HDP pregnancy. CHD incidence rates (per 10,000 person\u2010years) rose from 7.17 in women with no HDP pregnancies to 18.9 in women with one HDP pregnancy and 36.0 in women with recurrent HDP pregnancies as did stroke incidence rates (2.26, 5.22 and 11.1, respectively). All\u2010cause mortality rates did not differ by HDP status. After adjustment, compared with women with no HDP pregnancy, the risk of CHD was increased for recurrent HDP (HR, 1.86; 95% CI, 1.51\u20132.29) and one HDP (HR, 1.72; 95% CI, 1.50\u20131.97). Stroke risk was also elevated for women with recurrent HDP pregnancies (HR, 1.89; 95% CI, 1.29\u20132.76) and one pregnancy (HR, 1.62; 95% CI, 1.26\u20132.09). However, women with recurrent HDP were at similar risk of CHD and stroke when compared to women with one HDP pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CHD and stroke incidence rates roughly doubled with one and two or more HDP pregnancies while all\u2010cause mortality did not differ. However, while the risks of CHD and stroke were higher in women with recurrent HDP than in women with one HDP pregnancy, the differences were not statistically significant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70367","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T18:59:52Z","timestamp":1787338792000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Recurrent hypertensive disorders of pregnancy and subsequent maternal coronary heart disease, stroke, and all\u2010cause mortality"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4726-7848","authenticated-orcid":false,"given":"Dulaney A.","family":"Wilson","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6886-4807","authenticated-orcid":false,"given":"Julio","family":"Mateus","sequence":"additional","affiliation":[{"name":"Atrium Health Department of Obstetrics &amp; Gynecology Maternal\u2010Fetal Medicine Division  Charlotte North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Pittman","sequence":"additional","affiliation":[{"name":"Department of Medicine Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5399-8845","authenticated-orcid":false,"given":"Tanya N.","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Neurology Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8999-3587","authenticated-orcid":false,"given":"Kelly J.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5691-5347","authenticated-orcid":false,"given":"Angela M.","family":"Malek","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences Medical University of South Carolina  Charleston South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2013.05.005"},{"key":"e_1_2_10_3_1","unstructured":"Centers for Disease Control and Prevention.Pregnancy Mortality Surveillance System.2024. 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