Perinatal and Cardiovascular Epidemiology, Clinical Sciences Malmö, Lund University, Sweden (K.M., M.P., S.E., S.T.).
Departments of Obstetrics and Gynecology (K.M., S.T.), Skåne University Hospital, Lund and Malmö, Sweden.
Hypertension. 2024 Apr;81(4):897-905. doi: 10.1161/HYPERTENSIONAHA.123.22081. Epub 2024 Feb 22.
The extent to which a history of hypertensive disorders of pregnancy is associated with incident cardiovascular disease also among women with diabetes is unknown.
In this nationwide register-based cohort study, parous women aged 18 to 69 years with a first delivery in the Swedish Medical Birth Register, regardless of diabetic status at that time, and a subsequent clinical visit in the Swedish National Diabetes Register were included. Time to first cardiovascular disease event (myocardial infarction, stroke, or heart failure) before age 70 years by hypertensive disorders of pregnancy history was separately analyzed by diabetes type using Cox regression models that included conventional risk factors.
In total, 1748 (18.9%) of 9230 women with type 1 and 5904 (10.6%) of 55 773 women with type 2 diabetes had their first delivery complicated by a hypertensive disorder of pregnancy. Median time (25-75th percentile) between first delivery and start of follow-up was 3.3 (1.4-13.0) years for women with type 1 and 29.8 (22.4-35.6) years for women with type 2 diabetes. In modeling, the risk for any cardiovascular disease event among women with a history of hypertensive disorders of pregnancy was generally 10% to 20% higher, with main models estimating hazard ratios to 1.20 (95% CI, 0.99-1.47) for women with type 1 and 1.15 (95% CI, 1.02-1.29) for women with type 2 diabetes.
In women with diabetes, a history of hypertensive disorders of pregnancy was associated with an increased risk of incident cardiovascular disease and should be considered as a risk enhancer.
妊娠高血压疾病史与糖尿病女性发生心血管疾病事件的相关性尚不清楚。
在这项全国范围内基于登记的队列研究中，纳入了在瑞典医学出生登记处有首次分娩的年龄在 18 至 69 岁的经产妇，无论其当时是否患有糖尿病，且在瑞典国家糖尿病登记处有后续临床就诊，单独分析了妊娠高血压疾病史与不同类型糖尿病之间首次心血管疾病事件（心肌梗死、卒中和心力衰竭）的时间关系，采用 Cox 回归模型进行分析，模型中包含了常规危险因素。
共有 1748 名（18.9%）1 型糖尿病患者和 5904 名（10.6%）2 型糖尿病患者在首次分娩时伴有妊娠高血压疾病。1 型糖尿病患者首次分娩与随访开始之间的中位时间（25%-75%分位数）为 3.3（1.4-13.0）年，2 型糖尿病患者为 29.8（22.4-35.6）年。在建模中，妊娠高血压疾病史女性发生任何心血管疾病事件的风险通常增加 10%至 20%，主要模型估计的风险比为 1.20（95%CI，0.99-1.47），1 型女性为 1.15（95%CI，1.02-1.29））。
在患有糖尿病的女性中，妊娠高血压疾病史与发生心血管疾病事件的风险增加相关，应将其视为一个风险增强因素。
