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


METHODS
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).


RESULTS
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.


CONCLUSIONS
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.
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: r.scholten@obgyn.umcn.nl.
Ralph R
RR
Scholten
Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands; Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, England, UK.
Dick J H
DJ
Thijssen
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands.
Fred K
FK
Lotgering
Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands.
Maria T E
MT
Hopman
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, The Netherlands; Research School GROW, Maastricht University Medical Center, Maastricht, The Netherlands.
Marc E A
ME
Spaanderman
D000328:Adult; D000419:Albuminuria; D001341:Autonomic Nervous System / Q000502:physiology / Q000503:physiopathology*; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D001916:Brachial Artery / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D007328:Insulin / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000503:physiopathology*; D010809:Physical Fitness / Q000502:physiology; D011225:Pre-Eclampsia / Q000097:blood / Q000503:physiopathology*; D011247:Pregnancy; D040242:Risk Reduction Behavior
D001786:Blood Glucose; D007328:Insulin
dysfunction; endothelial function; exercise training; metabolic syndrome; preeclampsia