Background: Pregnant people with chronic hypertension, pre-existing diabetes or both are at high risk of developing cardiovascular disease. Lifestyle interventions play an important role in disease management in non-pregnant populations.
Aim: To review the existing evidence of randomised controlled trials (RCTs) that examine lifestyle interventions in pregnant people with chronic hypertension and/or pre-existing diabetes.
Methods: A systematic review and narrative synthesis was conducted. Five electronic databases were searched from inception to April 2021 for RCTs evaluating antenatal lifestyle interventions in people with chronic hypertension and/or pre-existing diabetes with outcomes to include weight or blood pressure change.
Results: Nine randomised controlled trials including 7438 pregnant women were eligible. Eight studies were mixed pregnant populations that included women with chronic hypertension and/or pre-existing diabetes. One study included only pregnant women with pre-existing diabetes. Intervention characteristics and procedures varied and targeted diet, physical activity and/or gestational weight. All studies reported weight and one study reported blood pressure change. Outcome data were frequently unavailable for the subset of women of interest, including subgroup data on important pregnancy and birth complications. Eligibility criteria were often ambiguous and baseline data on chronic hypertension was often omitted.
Conclusion: A lack of primary interventional trials examining the effect of lifestyle interventions on weight and blood pressure outcomes in pregnant populations with chronic hypertension and/or pre-existing diabetes was evident. Lifestyle modification has the potential to alter disease progression. Future trials should address the ambiguity and frequent exclusion of these important populations.
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http://dx.doi.org/10.1016/j.preghy.2022.12.004 | DOI Listing |
JAMA Neurol
December 2024
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Importance: Gestational hypertension, preeclampsia, and eclampsia are established risk factors for stroke and dementia later in life. Whether these pregnancy complications are associated with an increased risk of new-onset neurological disorders within months to years after giving birth is not known.
Objective: To explore whether gestational hypertension, preeclampsia, and eclampsia are associated with new-onset migraine, headache, epilepsy, sleep disorder, or mental fatigue within months to years after giving birth.
Cardiol Rev
December 2024
Departments of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Systemic hypertension is possibly the most important modifiable risk factor for the development of cognitive decline, both for mild cognitive impairment (MCI) and dementia. For effective blood pressure (BP) control, it requires proper assessment, using brachial, central, and ambulatory measurements, and monitoring with a focus on different BP parameters. Different BP parameters like pulse pressure, mean arterial pressure, BP variability, and circadian parameters, like nondippers and early morning surge, should be considered in the evaluation for the risk of cognitive decline due to hypertension in middle age and older adults.
View Article and Find Full Text PDFJ Prim Care Community Health
December 2024
Lehigh Valley Health Network Family Medicine Residency, Allentown, PA, USA.
Objective: Metabolic syndrome is a cluster of cardiovascular risk factors (central obesity, hypertension, dyslipidemia, and insulin resistance) that affects between 12.5% and 31.4% of adults worldwide.
View Article and Find Full Text PDFFront Cardiovasc Med
December 2024
Department of Community Health Sciences, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Introduction: The present study aimed to examine the additive interaction of family medical history of cardiovascular disease (CVD) and self-reported hypertension and diabetes on the diagnosis of CVD among older adults aged 45 years and above in India. A family medical history of CVD in individuals with hypertension and diabetes could identify a subpopulation with a higher risk of CVD.
Methods: The study used the data from the Longitudinal Ageing Study in India (LASI) Wave 1 (2017-2018).
World J Gastroenterol
December 2024
Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto M5G 1X8, Ontario, Canada.
In this article, we comment on the article by Qu and Li, focusing specifically on the non-invasive diagnostic approaches for metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD is the most common chronic liver disease in children. Nearly half of pediatric MASLD cases progress to metabolic dysfunction-associated steatohepatitis at diagnosis, often with comorbidities like renal disease, hypertension, type 2 diabetes, and mental health disorders.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!