Page 18 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

16 | Part 1 Introduction
glucose levels and higher cholesterol-levels. These symptoms are likely to co- occur as the metabolic syndrome (figure 1.4). The metabolic syndrome is defined as the presence of three or more of the following traits50 51:
 Abdominal obesity (waist circumference in men ≥ 102 cm, in women ≥ 88 cm)
 Elevated serum triglycerides (≥1.7 mmol/l) or drug treatment
 Low high-density lipoprotein (HDL) cholesterol (in men <1.0 mmol/l, in
women <1.3 mmol/l) or drug treatment
 Blood pressure ≥ 130/85 or drug treatment
 Elevated fasting plasma glucose (≥ 5.6 mmol/l) or drug treatment
The metabolic syndrome is not the only explanatory link between a complicated pregnancy and future cardiometabolic risk. Other risk factors like genetic predisposition and maybe the complicated pregnancy itself contribute to the increased future risk (figure 3).
Opportunities to reduce risk of future disease
Whether complicated pregnancy is a marker or a risk factor for future cardiometabolic disease does not alter the fact that the complicated pregnancy uniquely identifies these women at a young age as high risk for future disease. Since in the major part of these women classic risk factors like hypertension or hypercholesterolemia are not manifested jet, primary lifestyle intervention can help to postpone or even prevent future cardiometabolic disease. As shown by the INTERHEART study, lifestyle factors have a cumulative population attributive risk for cardiovascular disease in women of 65%52 indicating the possible gain of lifestyle intervention.
Smoking cessation reduces the risk for cardiovascular disease with 47% within 10 years, with the greatest effect in the first year after cessation53.