Risk of cardiovascular disease after pre-eclampsia and the effect of lifestyle interventions

A literature-based study

D Berks, M Hoedjes, H Raat, J J Duvekot, E A P Steegers, J D F Habbema

Research output: Contribution to journalReview articleScientificpeer-review

Abstract

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 PubMed 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.

Original languageEnglish
Pages (from-to)924-31
Number of pages8
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume120
Issue number8
DOIs
Publication statusPublished - Jul 2013
Externally publishedYes

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Odds Ratio
Smoking Cessation
PubMed

Keywords

  • Cardiovascular Diseases/epidemiology
  • Female
  • Humans
  • Life Style
  • Odds Ratio
  • Pre-Eclampsia/epidemiology
  • Pregnancy
  • Risk Factors

Cite this

@article{6e211eb95b11481da5aad8911579adaa,
title = "Risk of cardiovascular disease after pre-eclampsia and the effect of lifestyle interventions: A literature-based study",
abstract = "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 PubMed 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.",
keywords = "Cardiovascular Diseases/epidemiology, Female, Humans, Life Style, Odds Ratio, Pre-Eclampsia/epidemiology, Pregnancy, Risk Factors",
author = "D Berks and M Hoedjes and H Raat and Duvekot, {J J} and Steegers, {E A P} and Habbema, {J D F}",
note = "{\circledC} 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology {\circledC} 2013 RCOG.",
year = "2013",
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journal = "BJOG: An International Journal of Obstetrics and Gynaecology",
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Risk of cardiovascular disease after pre-eclampsia and the effect of lifestyle interventions : A literature-based study. / Berks, D; Hoedjes, M; Raat, H; Duvekot, J J; Steegers, E A P; Habbema, J D F.

In: BJOG: An International Journal of Obstetrics and Gynaecology, Vol. 120, No. 8, 07.2013, p. 924-31.

Research output: Contribution to journalReview articleScientificpeer-review

TY - JOUR

T1 - Risk of cardiovascular disease after pre-eclampsia and the effect of lifestyle interventions

T2 - A literature-based study

AU - Berks, D

AU - Hoedjes, M

AU - Raat, H

AU - Duvekot, J J

AU - Steegers, E A P

AU - Habbema, J D F

N1 - © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

PY - 2013/7

Y1 - 2013/7

N2 - 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 PubMed 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.

AB - 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 PubMed 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.

KW - Cardiovascular Diseases/epidemiology

KW - Female

KW - Humans

KW - Life Style

KW - Odds Ratio

KW - Pre-Eclampsia/epidemiology

KW - Pregnancy

KW - Risk Factors

U2 - 10.1111/1471-0528.12191

DO - 10.1111/1471-0528.12191

M3 - Review article

VL - 120

SP - 924

EP - 931

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 8

ER -