Page 98 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

96 | Part 3 Lifestyle intervention ABSTRACT
Objective This study addresses the following questions. Do cardiovascular risk factors fully explain the odds-ratio of cardiovascular risk after preeclampsia? What is the effect of lifestyle interventions (exercise, diet and smoking cessation) after preeclampsia on the risk of cardiovascular disease?
Design Literature based study.
Methods Data for the calculations were provided by studies, identified by
Pubmed searches. First, the differences in cardiovascular risk factors after preeclampsia compared to 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-ratio of preeclampsia for ischaemic heart disease is 1.89(1.76-1.98), and for stroke it is 1.55(1.40-1.71). Lifestyle interventions after preeclampsia on exercise, dietary habits and smoking cessation decreases cardiovascular risk with an odds-ratio of 0.91 (0.87-0.96).
Conclusion Cardiovascular risk factors do not fully explain the risk of cardiovascular disease after preeclampsia. The gap between estimated and observed odds-ratios may be explained by an additive risk of cardiovascular disease by preeclampsia. Furthermore, lifestyle interventions after preeclampsia seem effective in decreasing cardiovascular risk. Future research is needed to overcome the numerous assumptions we had to make in our calculations.