Evidence-based strategies for reducing cardiovascular risk in preterm-born individuals
| Strategy | Evidence level | Key considerations |
|---|---|---|
| Nutritional interventions | Moderate (RCTs, observational) | Vitamin D supplementation, balanced catch-up growth, omega-3 fatty acids |
| Blood pressure screening | High (guideline-based) | Regular pediatric checks, possible 24 h ambulatory BP monitoring for high-risk groups |
| Echocardiographic follow-up | Moderate-high (cohort studies) | TDI, speckle-tracking for early detection of LV dysfunction, especially in extremely preterm survivors |
| Lifestyle & exercise programs | Moderate (some RCTs in pediatrics) | Emphasize moderate activity to prevent obesity and insulin resistance |
| Antihypertensive therapy | Emerging evidence | Early ACE inhibitors or ARBs may halt progression of LV hypertrophy; requires further pediatric trials |
| Telemedicine & mHealth | Growing (pilot programs, LMICs data) | Addresses follow-up gaps, especially in rural/low-resource settings |
| Environmental exposure mitigation | Moderate (epidemiological data) | Reduction of maternal exposure to toxic metals (lead, mercury, arsenic) and pollutants |
| Maternal health optimization | High (strong epidemiological links) | Control of maternal BMI, BP, glycemic status (preconception & prenatal) to lower PTB and subsequent risks |
This table highlights selected evidence-based interventions; ongoing research may refine these strategies further. LMICs: low- and middle-income countries; TDI: tissue doppler imaging; BMI: body mass index