Impact of different hypertensive disorders of pregnancy on cardiovascular disease risk and all-cause mortality in women with type 1 diabetes
Authors' conclusion
Hypertension during pregnancy is associated with increased risk of cardiovascular events during long-term follow-up in women with T1D, with pre-eclampsia conferring the highest risk. For all-cause mortality, chronic hypertension and pre-eclampsia, but not gestational hypertension, increases the risk of death, yet not independently of diabetic kidney disease.
Study context
- Population
- Women with T1D delivering 1988–1994 at Helsinki University Hospital, later re-examined in the Finnish Diabetic Nephropathy Study; median age at delivery 29.4 (IQR 26.0–33.3) years
- Participants
- 190 women
- Exposure
- Pre-eclampsia, gestational hypertension or chronic hypertension vs no hypertensive disorder during pregnancy
- Pre-eclampsian = 43
- Gestational hypertensionn = 32
- Chronic hypertensionn = 20
- Normotensiven = 95reference
- Outcome
- Cardiovascular disease (composite cardiovascular event) and all-cause mortality
- Follow-up
- Median 27.9 (25.4-30.7) years
Methodological detailssingle-centre, registry follow-up, Follow-up data from national registries until the end of 2020
- Single-centre
- Registry follow-up
- Follow-up data from national registries until the end of 2020
Main finding
As reported in the abstract
Composite cardiovascular event (adjusted for delivery age and age at T1D onset) · median 27.9 years
Each group vs normotensiveHazard ratio (95% CI)
Chronic hypertension
3.45(1.25–9.54)
Gestational hypertension
3.63(1.55–8.51)
Pre-eclampsia
5.07(2.31–11.11)
- Composite cardiovascular event, whole cohort
- 46 (24.2%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| All-cause mortality (adjusted for delivery age and age at T1D onset) · median 27.9 yearsChronic hypertensionvs NormotensiveCox regression | 3.31 (1.06–10.35) | |
| All-cause mortality (adjusted for delivery age and age at T1D onset) · median 27.9 yearsPre-eclampsiavs NormotensiveCox regression | 2.92 (1.07–7.98) | |
| All-cause mortality (adjusted for delivery age and age at T1D onset) · median 27.9 yearsGestational hypertensionvs NormotensiveCox regression | 1.26 (0.33–4.85) | |
| 0.050.21520Hazard ratio (log scale) |
- All-cause mortality (adjusted for delivery age and age at T1D onset) — Died from any cause, whole cohort
- 25 (13.2%)
All-cause mortality (adjusted for delivery age and age at T1D onset) · median 27.9 years
- After further adjustment for DKD or DR, none of the mortality associations were significant
Original publication
Impact of different hypertensive disorders of pregnancy on cardiovascular disease risk and all-cause mortality in women with type 1 diabetes. Cardiovasc Diabetol. Published 14 June 2025. doi:10.
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