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Risk of cardiovascular disease after pre‐eclampsia and the effect of lifestyle interventions: a literature‐based study
Author(s) -
Berks D,
Hoedjes M,
Raat H,
Duvekot JJ,
Steegers EAP,
Habbema JDF
Publication year - 2013
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12191
Subject(s) - medicine , eclampsia , odds ratio , disease , psychological intervention , odds , physical therapy , stroke (engine) , smoking cessation , risk factor , obstetrics , pregnancy , logistic regression , pathology , psychiatry , mechanical engineering , genetics , engineering , biology
Objective This study addresses the following questions. Do cardiovascular risk factors fully explain the odds ratio of cardiovascular risk after pre‐eclampsia? What is the effect of lifestyle interventions (exercise, diet, and smoking cessation) after pre‐eclampsia on the risk of cardiovascular disease? Design Literature‐based study. Setting N/A. Population or Sample N/A. Methods Data for the calculations were taken from studies identified by P ub M ed searches. First, the differences in cardiovascular risk factors after pre‐eclampsia compared with an uncomplicated pregnancy were estimated. Second, the effects of lifestyle interventions on cardiovascular risk were estimated. Validated risk prediction models were used to translate these results into cardiovascular risk. Results After correction for known cardiovascular risk factors, the odds ratios of pre‐eclampsia for ischaemic heart disease and for stroke are 1.89 ( IQR 1.76–1.98) and 1.55 ( IQR 1.40–1.71), respectively. After pre‐eclampsia, lifestyle interventions on exercise, dietary habits, and smoking cessation decrease cardiovascular risk, with an odds ratio of 0.91 ( IQR 0.87–0.96). Conclusions Cardiovascular risk factors do not fully explain the risk of cardiovascular disease after pre‐eclampsia. The gap between estimated and observed odds ratios may be explained by an additive risk of cardiovascular disease by pre‐eclampsia. Furthermore, lifestyle interventions after pre‐eclampsia seem to be effective in decreasing cardiovascular risk. Future research is needed to overcome the numerous assumptions we had to make in our calculations.