Cardiovascular effects of aerobic exercise training in formerly preeclamptic women and healthy parous control subjects

• Published in: American journal of obstetrics and gynecology Vol. 211; no. 5; pp. 516.e1 - 516.e11
• Main Authors: Scholten, Ralph R., Thijssen, Dick J.H., Lotgering, Fred K., Hopman, Maria T.E., Spaanderman, Marc E.A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2014
• Subjects: Adult; Albuminuria; Autonomic Nervous System - physiology; Autonomic Nervous System - physiopathology; Blood Glucose - metabolism; Blood Pressure - physiology; Brachial Artery - physiopathology; Cardiovascular Diseases - blood; Cardiovascular Diseases - physiopathology; Carotid Intima-Media Thickness; Case-Control Studies; dysfunction; endothelial function; Endothelium, Vascular - physiopathology; Exercise; Exercise Therapy - methods; exercise training; Female; Femoral Artery - physiopathology; Humans; Insulin - blood; metabolic syndrome; Metabolic Syndrome - blood; Metabolic Syndrome - physiopathology; Obstetrics and Gynecology; Physical Fitness - physiology; Pre-Eclampsia - blood; Pre-Eclampsia - physiopathology; preeclampsia; Pregnancy; Risk Reduction Behavior; endothelial function; metabolic syndrome; preeclampsia; exercise training; dysfunction
• ISSN: 0002-9378; 1097-6868; 1097-6868
• DOI: 10.1016/j.ajog.2014.04.025

Women who have had preeclampsia demonstrate higher prevalence of metabolic syndrome (MetS), impaired vascular function, and increased sympathetic activity and are at increased risk of cardiovascular disease. The aim of this study was to assess the effects of 12 weeks of exercise training (70-80% maximum volume of oxygen utilization) in women who had had preeclampsia on physical fitness, components of MetS, vasculature, and autonomic functions compared with healthy control subjects. Our prospective case-control study included 24 normotensive women who had had preeclampsia and 20 control subjects who were matched for age and postpartum interval (all 6-12 months after delivery). Before and after training, we measured all components of MetS (ie, BP, lipids, glucose/insulin, and albuminuria), carotid intima media thickness (IMT) and brachial and superficial femoral artery endothelial function that used flow-mediated dilation (FMD). Autonomic activity was quantified with power spectral analysis (low-frequency/high-frequency power [LF/HF] ratio). At baseline, women who had had preeclampsia demonstrated higher values of most components of MetS. Compared with the control subjects, women who had had preeclampsia had increased IMT (580 ± 92 μm vs 477 ± 65 μm, respectively), impaired endothelial function (FMD brachial artery, 5.3% ± 2.2% vs 10.8% ± 3.5%, respectively; FMD superficial femoral artery, 4.9% ± 2.1% vs 8.7% ± 3.2%, respectively) and increased LF/HF power ratio (2.2 ± 1.0 vs 1.3 ± 0.4, respectively; all P < .05). In both groups, exercise training decreased values of most components of MetS and IMT, improved FMD, and concurrently reduced LF/HF. Despite these improvements, vascular and autonomic variables did not normalize by 12 weeks of training in women who had had preeclampsia. This study demonstrates that exercise training in women who had had preeclampsia and control subjects improves components of MetS, endothelial function, vascular wall thickness, and autonomic control. Nonetheless, trained women who had had preeclampsia only reached a cardiovascular status that is comparable with sedentary healthy control subjects.