Gestational diabetes tied to increased CVD risks

Women with gestational diabetes are at heightened risks of overall and specific cardiovascular diseases (CVDs), including chronic hypertension, according to a nationwide population‐based cohort study.

Researchers used data from the French national Programme de Médicalisation des Systèmes d'Information. They identified 1,436,468 parous women who had no history of CVD or chronic hypertension in the 5 years preceding or during the pregnancy.

Outcomes of interest included incident hospitalization for chronic hypertension and CVD events. The composite CVD outcome was defined as hospitalization for coronary artery disease, heart failure, or stroke. Coronary heart disease (angina pectoris, myocardial infarction, and coronary revascularization), heart failure, and cerebrovascular disease (haemorrhagic and ischaemic stroke, transient ischaemic attack, and carotid revascularization) were also assessed individually.

Of the women, 101,814 had a history of gestational diabetes. This group had a 97-percent higher risk of chronic hypertension (hazard ratio [HR], 1.97, 95 percent confidence interval [CI], 1.89–2.06) and a 31-percent higher overall CVD risk (HR, 1.31, 95 percent CI, 1.22–1.41) compared with those who had no history of gestational diabetes (control).

The gestational diabetes group also showed greater risks of specific CVDs, including coronary heart disease (HR, 1.71, 95 percent CI, 1.50–1.94]), heart failure (HR, 1.41, 95 percent CI, 1.21–1.65), and stroke (HR, 1.16, 95 percent CI, 1.06–1.28) relative to the control group.

The risk increase was already evident at 1 year postpartum for chronic hypertension and CVD outcomes and was more pronounced among women with ≥2 pregnancies complicated by gestational diabetes than among those who had a history of only one episode of gestational diabetes.