Key result
A 6-month nutritional and cardiovascular exercise intervention starting 6 weeks postpartum reduced arterial stiffness (pulse wave velocity) to 6.36 m/s compared to 7.33 m/s in the control group (d = 0.65).
Why the study?
Women face an increased lifetime risk of cardiovascular morbidity and mortality after hypertensive disorders of pregnancy, and arterial stiffness is a modifiable target parameter for risk reduction.
Does a 6-month nutritional and exercise intervention reduce arterial stiffness in women following severe hypertensive disorders of pregnancy?
RCT (n=76)
Open-label
1:1 using a web-based random generator
Yes
Does a 6-month nutritional and exercise intervention reduce arterial stiffness in women following severe hypertensive disorders of pregnancy?
Standardized Mean Difference: 0.65
Absolute Event Rate: 6.36% vs 7.33%
p-value: p=0.632
A 6-month postpartum lifestyle intervention combining exercise and nutritional counseling reduced arterial stiffness in women with prior severe hypertensive disorders of pregnancy to levels comparable to healthy controls, though the study was underpowered for statistical significance.
Lifestyle intervention may lower arterial stiffness postpartum after HDP; leaves open long-term CV outcome benefits in this population.
Background Women have a markedly increased lifetime risk for cardiovascular morbidity and mortality following hypertensive disorders of pregnancy. Arterial stiffness is regarded as a target parameter for reducing cardiovascular risk and can be modified by lifestyle changes. Methods In a prospective, randomised, controlled interventional study, starting 6 weeks postpartum, the effect of nutritional intervention combined with an intensive 6-month cardiovascular exercise programme on arterial stiffness was investigated by means of pulse wave velocity (PWV) in 38 women with severe hypertensive disorder of pregnancy (preeclampsia with or without pre-existing hypertension and/or HELLP syndrome). A reference group was formed with postpartum women without pregnancy complications or known cardiovascular risk and the arterial stiffness was studied by means of PWV at the time of delivery. The PWV was measured in the intervention and control groups within a week after delivery and after 32 weeks (6 weeks + 6 months). A feasibility analysis was performed in addition. Results 29 of 38 women with severe hypertensive disorder of pregnancy and 38 postpartum women in the reference group were included in the analysis (intervention group n = 14; control group n = 15; reference group n = 38). Adherence to a) the nutritional counselling and b) the intensive cardiovascular exercise programme was 73% and 79% respectively. A clinically significant difference (d = 0.65) in pulse wave velocity between the intervention and control groups was found after 6 months (6.36 ± 0.76 vs. 7.33 ± 2.25 m/s; group × time: p = 0.632). The PWV of the intervention group corresponded to that of the reference group at the end of the study (6.36 ± 0.76 m/s vs. 6.5 ± 0.70; d = 0.19), while the results in the control group differed markedly from this (7.33 ± 2.25 m/s; d = 0.56). Conclusion The study documents the feasibility of lifestyle intervention with physical exercise after delivery (starting 6 weeks postpartum). The intervention showed a significant clinical effect by reducing arterial stiffness to the level of the reference group. Before this intervention can be included in the standard of care and prevention, follow-up studies must confirm these results and the medium-term effects on cardiovascular risk.
No takes yet. Share an insight, caveat, or question.
Riemer et al. (2021) conducted an RCT in Severe hypertensive disorder of pregnancy (preeclampsia and/or HELLP syndrome) (n=76). Nutritional counselling and 6-month cardiovascular exercise programme vs. Standard care was evaluated on Aortic pulse wave velocity (aPWV) at 32 weeks postpartum (d = 0.65, p=0.632). A 6-month nutritional and cardiovascular exercise intervention starting 6 weeks postpartum reduced arterial stiffness (pulse wave velocity) to 6.36 m/s compared to 7.33 m/s in the control group (d = 0.65).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: