Page 100 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

98 | Part 3 Lifestyle intervention
factors fully explain the increased odds-ratios of cardiovascular risk after preeclampsia? What is the effect of lifestyle interventions after preeclampsia on the risk of cardiovascular disease?
MATERIAL AND METHODS
Estimating both the contribution of cardiovascular risk factors, as well as preeclampsia itself, on cardiovascular risk and the effect of lifestyle interventions on cardiovascular risk involves a number of steps. The estimation process is visualised in figure 3.2.1.
Cardiovascular risk after preeclampsia (steps 1a-1f)
In step 1a we searched for studies that reported on differences in cardiovascular risk factors between women with a history of preeclampsia compared to women with a history of an uncomplicated pregnancy. We focused on cardiovascular risk factors used in the prediction models in step 1c: systolic and diastolic blood pressure, cholesterol levels, weight, smoking, diabetes, familial cardiovascular disease and the level of C-reactive protein. A Pubmed search with the term “preeclampsia AND risk factors AND cardiovascular disease” was used to identify original case/control studies that reported on these cardiovascular risk factors after preeclampsia, see Figure 2. Preeclampsia was according to the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria, defined as a blood pressure of 140/90 mmHg or higher and proteinuria of at least 300 mg/day at a gestational age of at least 20 weeks. Studies with women with chronic hypertension were allowed, but we excluded studies that included women with pre-existing renal or cardiovascular disease. As for this and all other searches (steps 1c and 2a), publications until January