Hypertensive Pregnancy Disorders Linked to Long-Term Cardiovascular Risk in Women with Type 1 Diabetes: Study
Finland: A new study published in Cardiovascular Diabetology highlights that hypertensive pregnancy disorders significantly raise the risk of cardiovascular disease (CVD) in women with type 1 diabetes (T1D), highlighting the importance of obstetric history in long-term cardiovascular risk assessment for these patients. The research, led by Dr. Kaarina Rimpeläinen from the Folkhälsan Research Center in Helsinki, Finland, also found that certain pregnancy-related hypertensive conditions may impact all-cause mortality.
The study analyzed data from 190 women with T1D who had delivered between 1988 and 1994 at Helsinki University Hospital. Participants, with a median delivery age of 29.4 years, were followed for nearly three decades as part of the Finnish Diabetic Nephropathy Study. Their pregnancy histories were categorized into four groups: pre-eclampsia, gestational hypertension, chronic hypertension, or no hypertensive disorder during pregnancy. Data on cardiovascular events and mortality were obtained from national registries through the end of 2020.
The key findings were as follows:
- During a median follow-up of 27.9 years, 24.2% of participants experienced cardiovascular events.
- 13.2% of participants died from any cause over the follow-up period.
- Women with a history of pre-eclampsia had the highest risk of future cardiovascular events (HR 5.07).
- Women with a history of gestational hypertension had an increased risk of cardiovascular events (HR 3.63).
- Women with a history of chronic hypertension also showed elevated cardiovascular risk (HR 3.45).
- All-cause mortality risk was higher in women with prior chronic hypertension (HR 3.31).
- All-cause mortality risk was elevated in women with pre-eclampsia (HR 2.92).
- There was no significant increase in all-cause mortality in women with gestational hypertension.
- After adjusting for diabetic kidney disease or diabetic retinopathy, the association between hypertensive pregnancy disorders and cardiovascular disease risk remained significant for pre-eclampsia and gestational hypertension.
- After the same adjustment, the association between hypertensive pregnancy disorders and all-cause mortality was no longer statistically significant.
The authors noted several limitations, including incomplete data on milder forms of albuminuria before pregnancy and a lack of information from every pregnancy for each participant. The chronic hypertension group was also heterogeneous, making it difficult to distinguish cases of superimposed pre-eclampsia.
Despite the relatively small cohort, the extended follow-up period and comprehensive evaluation of DKD and diabetic retinopathy strengthened the study’s findings. The results emphasize the need for clinicians to consider pregnancy complications when assessing cardiovascular risk in women with T1D.
“Women with type 1 diabetes who have a history of hypertensive pregnancy are at greater risk for cardiovascular events later in life,” the authors concluded. They advocate for more proactive CVD prevention in this group, along with improved coordination between obstetric and diabetes care teams to ensure long-term cardiovascular health.
Reference:
Rimpeläinen, K., Jansson Sigfrids, F., Gordin, D. et al. Impact of different hypertensive disorders of pregnancy on cardiovascular disease risk and all-cause mortality in women with type 1 diabetes. Cardiovasc Diabetol 24, 255 (2025). https://doi.org/10.1186/s12933-025-02804-7
