Exercise improved vascular function and fitness, telemonitored home BP monitoring lowered blood pressure, while web-based interventions did not reduce CVD risk factors in women post-preeclampsia.
Do lifestyle and medical interventions reduce the risk of cardiovascular disease in women with a history of preeclampsia?
There is a paucity of research on CVD risk reduction in women after preeclampsia, though exercise, home BP monitoring, and multidisciplinary clinics show promise in improving surrogate markers and risk factors.
Absolute Event Rate: 0% vs 0%
Abstract Background Preeclampsia (PE) affects 2-4% of pregnancies worldwide and is associated with significant morbidity and mortality (1). It is now known that PE also increases risk of later-life cardiovascular disease (CVD). Current international guidelines acknowledge this risk. However, all guidelines differ and there remains no consensus on specific risk-reduction strategies in this high-risk group (2-4). Objectives The aim of this review was to assess all interventions which have been trialled in women with a history of PE to reduce risk of long-term CVD. Methods A systematic search of MEDLINE, EMBASE and CINAHL was performed according to PRISMA guidelines, to identify all studies which explored interventions to reduce risk of future CVD in women with a history of PE. Primary outcomes included CVD outcomes including ischaemic heart disease and stroke. Secondary outcomes included subclinical atherosclerosis and subjective markers of CVD. Results 8 studies including 728 women were included in the final analysis. 4 studies explored exercise interventions, 2 assessed web-based interventions, 1 studied a multidisciplinary clinic and 1 studied telemonitored home blood pressure (BP) monitoring. Studies were heterogeneous with respect to duration, timing postpartum and outcomes. Only 1 study explored CVD outcomes. Overall, exercise improved physical fitness, endothelial and autonomic function and vascular stiffness. Web-based interventions were well received but did not reduce CVD risk factors. Telemonitored home BP monitoring significantly lowered BP and readmissions for hypertension. The Postpartum Preeclampsia clinic reduced CVD risk factors. Conclusions This review highlights the challenges associated with CVD risk reduction in women with a history of PE and the paucity of research in this area. Optimal strategy is likely to involve early education, a dedicated exercise program and a web-based platform. Larger studies with longer follow up are required to determine optimal strategies for CVD risk prevention in this cohort.
Yao et al. (Sat,) reported a other. Exercise improved vascular function and fitness, telemonitored home BP monitoring lowered blood pressure, while web-based interventions did not reduce CVD risk factors in women post-preeclampsia.