Key result
Lifestyle modifications reduce DBP by ~3 mm Hg and improve fasting glucose in premenopausal women.
Why the study?
Non-traditional risk factors place young women at increased lifetime risk of CVD, but the effectiveness of primary prevention interventions in premenopausal women required evaluation.
Do primary prevention interventions improve cardiovascular disease risk factors in premenopausal women compared to usual practice?
Meta-Analysis
Do primary prevention interventions improve cardiovascular disease risk factors in premenopausal women compared to usual practice?
Lifestyle modification programs involving education, counseling, and follow-ups effectively improve cardiovascular risk factors such as diastolic blood pressure and fasting glucose in premenopausal women.
Lifestyle programs merit consideration for risk-factor control in premenopausal women; extends meta-analytic evidence to this group.
OBJECTIVES: Non-traditional risk factors place young women at increased risk of cardiovascular disease (CVD) over their lifetime. The current study undertakes a systematic review and meta-analysis of randomised controlled trials (RCTs) that examined the effectiveness of primary prevention interventions for CVD in premenopausal women. METHODS: An electronic literature search was performed in key databases in July 2018 and updated in May 2020. RCTs that recruited predominately female participants with a proportion aged under 55 years and that compared primary prevention interventions of CVD with usual practice were included. Two reviewers undertook the selection process for study inclusion. Meta-analysis was conducted for studies based on the same intervention in order to synthesise the results. RESULTS: 14 RCTs with sample size ranging from 49 to 39 876 were included. Interventions included diet (2), vitamin E/antioxidants (3), lifestyle modification programme (7) and aspirin (2). The meta-analysis results indicated that diet nor vitamin E/antioxidant did not significantly lower the CVD risk profiles, while lifestyle modification programme involving components of lifestyle education, counselling and multiple follow-ups showed great potential to improve risk profiles. The lifestyle modification intervention improved blood pressure (-2.11 mm Hg, 95% CI -4.32 to 0.11, for systolic and -3.31 mm Hg (95% CI -4.72 to -1.91, for diastolic), physical activity (30.72 MET-min/week, 95% CI 23.57 to 37.87, for moderate physical activity 12.70 MET-min/week, 95% CI 8.27 to 17.14, for vigorous physical activity) and fasting blood glucose (-0.37 mmol/L, 95% CI -0.58 to -0.15). Subgroup meta-analysis in studies with a mean age under 51 years old suggested that lifestyle modification intervention remained to be effective in improving physical activity and fasting blood glucose. CONCLUSION: The effective interventions identified in this review although with a small sample size and short duration could potentially inform future design of primary prevention of CVD in premenopausal women.
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Gao et al. (2021) conducted a meta-analysis in Cardiovascular disease. Primary prevention interventions (diet, vitamin E/antioxidants, lifestyle modification, aspirin) vs. Usual practice was evaluated on Cardiovascular disease risk profiles. Lifestyle modification programs improved diastolic blood pressure (-3.31 mm Hg; 95% CI -4.72 to -1.91) and fasting blood glucose (-0.37 mmol/L; 95% CI -0.58 to -0.15) in premenopausal women.
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