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Pre\u2010eclampsia is not only a major cause of maternal morbidity and mortality, but also a significant risk factor for the development of later\u2010life cardiovascular disease. However, the specific mechanisms underlying the pathophysiology of pre\u2010eclampsia, as well as the mechanisms for an increased susceptibility to cardiovascular disease later in life, are not fully characterized. In this review, we discuss the concept that excessive\n                    <jats:italic>pregnancy\u2010specific<\/jats:italic>\n                    dyslipidaemia, particularly hypercholesterolaemia, is a significant risk factor for the development of pre\u2010eclampsia. We further outline novel potential mechanisms (i.e. oxidized low\u2010density lipoprotein receptor 1 and toll\u2010like receptor 4) underlying endothelial dysfunction induced by excessively high cholesterol levels during pregnancy (in the context of pre\u2010eclampsia), in addition to discussing the overall implications of having had a pregnancy complicated by pre\u2010eclampsia on later\u2010life maternal vascular health. Determining the mechanisms by which excessive,\n                    <jats:italic>pregnancy\u2010specific<\/jats:italic>\n                    dyslipidaemia\/hypercholesterolaemia impact maternal endothelial health in pregnancy, and later in life, will create a window of opportunity to diagnose and develop targeted therapy for a susceptible population of women, aiming to ultimately reduce the societal burden of cardiovascular disease.\n                    <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/tjp16485-gra-0001-m.png\">\n                        <jats:alt-text>image<\/jats:alt-text>\n                      <\/jats:graphic>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1113\/jp285943","type":"journal-article","created":{"date-parts":[[2024,12,26]],"date-time":"2024-12-26T12:58:49Z","timestamp":1735217929000},"page":"4302-4317","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Excessive hypercholesterolaemia during pregnancy as a risk factor for endothelial dysfunction in pre\u2010eclampsia"],"prefix":"10.1113","volume":"604","author":[{"given":"Amanda A.","family":"de Oliveira","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Alberta  Edmonton AB Canada"},{"name":"Women and Children's Health Research Institute University of Alberta  Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floor","family":"Spaans","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Alberta  Edmonton AB Canada"},{"name":"Women and Children's Health Research Institute University of Alberta  Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christy\u2010Lynn M.","family":"Cooke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Alberta  Edmonton AB Canada"},{"name":"Women and Children's Health Research Institute University of Alberta  Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra T.","family":"Davidge","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Alberta  Edmonton AB Canada"},{"name":"Women and Children's Health Research Institute University of Alberta  Edmonton AB Canada"},{"name":"Department of Physiology University of Alberta  Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,26]]},"reference":[{"issue":"1","key":"e_1_2_3_2_1","first-page":"394","article-title":"Gestational lipid profile as an early marker of metabolic syndrome in later life: A population\u2010based prospective cohort study","volume":"18","author":"Adank M. 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