Another meta-analysis by Bellamy et al180 cohort studies and reported a cumulative OR of 1.81 for any stroke (OR, 1.81; 95% CI, 1.37 2.33) in women with a history of preeclampsia, whereas Brown et al184 noted an OR of 1.76 for cerebrovascular disease (95% CI, 1.43 2.21) for women with a history of pregnancies with preeclampsia. In one study, the mean age at stroke onset was 50 years in women with these disorders, which suggests an accelerated time course to severe CVD or cerebrovascular disease, as well as loss or attenuation of women s premenopausal cardiovascular advan- Early- onset preeclampsia (before 32 weeks gestation) in particular has been noted to increase risk for stroke 5-fold compared with later-onset preeclampsia.186 Early-onset pre- eclampsia is also associated with an increase in white mat- ter lesions independent of hypertension in women years after pregnancies complicated by preeclampsia or eclampsia, which suggests a vulnerability to future events.187 The basis of the association between preeclampsia and future stroke is not entirely known but is hypothesized to be possibly related to genetic factors; shared risk factors (hyper- tension, dyslipidemia, endothelial dysfunction) between pre- eclampsia/eclampsia or other pregnancy complications and stroke; unmasking of underlying metabolic or vascular dis- ease; or the induction during pregnancy of cardiovascular or cerebrovascular abnormalities that persist long-term.188 To assess the contribution by preeclampsia/eclampsia to future risk for CVD and stroke and the possible impact that lifestyle interventions may have on this risk, Berks et al189 performed a series of literature-based calculations on risk estimates. First, using a meta-analysis cumulative OR for stroke as the start- ing point, they found that preeclampsia increased the odds of stroke by 1.55-fold after correction for cardiovascular risk factors (interquartile range 1.76 1.98). This result suggests Table 5. 