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
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