Understanding Umbrella Review of the Cardiovascular Research

Borges, Leonardo Silva Roever; Biondi‐Zoccai, Giuseppe

doi:10.5935/2359-4802.20160066

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…Several systematic reviews have looked at risk factors specific to women and cardiovascular disease but they evaluated different risk factors and different outcomes. An umbrella review is a review of existing systematic reviews and meta-analyses 35…”

Section: Introductionmentioning

confidence: 99%

Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review

Okoth

Chandan

Marshall

et al. 2020

BMJ

246

171

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Objective To consolidate evidence from systematic reviews and meta-analyses investigating the association between reproductive factors in women of reproductive age and their subsequent risk of cardiovascular disease. Design Umbrella review. Data sources Medline, Embase, and Cochrane databases for systematic reviews and meta-analyses from inception until 31 August 2019. Review methods Two independent reviewers undertook screening, data extraction, and quality appraisal. The population was women of reproductive age. Exposures were fertility related factors and adverse pregnancy outcomes. Outcome was cardiovascular diseases in women, including ischaemic heart disease, heart failure, peripheral arterial disease, and stroke. Results 32 reviews were included, evaluating multiple risk factors over an average follow-up period of 7-10 years. All except three reviews were of moderate quality. A narrative evidence synthesis with forest plots and tabular presentations was performed. Associations for composite cardiovascular disease were: twofold for pre-eclampsia, stillbirth, and preterm birth; 1.5-1.9-fold for gestational hypertension, placental abruption, gestational diabetes, and premature ovarian insufficiency; and less than 1.5-fold for early menarche, polycystic ovary syndrome, ever parity, and early menopause. A longer length of breastfeeding was associated with a reduced risk of cardiovascular disease. The associations for ischaemic heart disease were twofold or greater for pre-eclampsia, recurrent pre-eclampsia, gestational diabetes, and preterm birth; 1.5-1.9-fold for current use of combined oral contraceptives (oestrogen and progesterone), recurrent miscarriage, premature ovarian insufficiency, and early menopause; and less than 1.5-fold for miscarriage, polycystic ovary syndrome, and menopausal symptoms. For stroke outcomes, the associations were twofold or more for current use of any oral contraceptive (combined oral contraceptives or progesterone only pill), pre-eclampsia, and recurrent pre-eclampsia; 1.5-1.9-fold for current use of combined oral contraceptives, gestational diabetes, and preterm birth; and less than 1.5-fold for polycystic ovary syndrome. The association for heart failure was fourfold for pre-eclampsia. No association was found between cardiovascular disease outcomes and current use of progesterone only contraceptives, use of non-oral hormonal contraceptive agents, or fertility treatment. Conclusions From menarche to menopause, reproductive factors were associated with cardiovascular disease in women. In this review, presenting absolute numbers on the scale of the problem was not feasible; however, if these associations are causal, they could account for a large proportion of unexplained risk of cardiovascular disease in women, and the risk might be modifiable. Identifying reproductive risk factors at an early stage in the life of women might facilitate the initiation of strategies to modify potential risks. Policy makers should consider incorporating reproductive risk factors as part of the assessment of cardiovascular risk in clinical guidelines. Systematic review registration PROSPERO CRD42019120076.

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Section: Introductionmentioning

confidence: 99%

Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review

Okoth

Chandan

Marshall

et al. 2020

BMJ

246

171

View full text Add to dashboard Cite

show abstract

“…An umbrella review is a review of existing systematic reviews and meta-analyses. 35 The aim of the study was to conduct an umbrella review of systematic reviews evaluating the association between risk factors specific to women (adverse pregnancy outcomes and issues related to fertility) and cardiovascular disease outcomes. This umbrella review will provide decision makers with a consolidated source of high quality studies on this subject.…”

Section: Introductionmentioning

confidence: 99%

Association Between the Reproductive Health of Young Women and Cardiovascular Disease in Later Life: Umbrella Review

Okoth¹,

Chandan²,

Marshall³

et al. 2021

Obstetric Anesthesia Digest

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Understanding Umbrella Review of the Cardiovascular Research

Cited by 2 publications

References 10 publications

Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review

Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review

Association Between the Reproductive Health of Young Women and Cardiovascular Disease in Later Life: Umbrella Review

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