Page 99 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

3.2 Effect of Lifestyle Interventions after Preeclampsia| 97
INTRODUCTION
Preeclampsia occurs as a complication in 2-8% of pregnancies4. After preeclampsia, women have an increased risk of cardiovascular disease, including ischaemic heart disease and stroke2. Moreover, since preeclampsia and cardiovascular disease share most risk factors like hypertension, obesity, diabetes, and hypercholesterolemia195 196, preeclampsia functions as a marker for cardiovascular risk1. However, it is not yet known whether preeclampsia itself independently adds to cardiovascular risk197 198. If this is true, then preeclampsia would be an independent risk factor, and not just a marker for cardiovascular disease.
Furthermore, the burden of cardiovascular disease in women is high. In 2004 cardiovascular disease accounted for 57.0% of global female mortality199. This emphasises the need for preventive lifestyle (or medical) interventions. Early detection of high-risk individuals maximises the effect of such interventions. After preeclampsia, women are thought to be good subjects for such interventions, since they are young and probably well motivated. Other authors have indeed suggested postpartum lifestyle interventions after preeclampsia to lower cardiovascular risk4 197. However, although previous research has shown that lifestyle interventions are effective if cardiovascular risk factors are already present200, the effect remains uncertain in the absence of cardiovascular risk factors201. Thus, since the majority of women after preeclampsia have no cardiovascular risk factors202 and studies of post- preeclamptic lifestyle interventions are lacking, possible effects remain unknown. However, effects of lifestyle interventions after preeclampsia could be estimated.
This study addressed the following questions. Do cardiovascular risk