Hysterectomy may indicate cardiovascular risk in women under age 50
Hysterectomy may be a marker of early cardiovascular risk and disease, especially in women under 35, according to Mayo Clinic experts.
In a study recently published in Menopause: The Journal of the North American Menopause Society, researchers found that women who underwent hysterectomy were much more likely to have pre-existing cardiovascular risk factors – especially obesity – than women of the same age in the control group who did not undergo hysterectomy. In particular, women under age 35 had the most cardiovascular risk factors and disease, including stroke.
“Cardiovascular disease is the leading cause of death among women, and women see primarily gynecologists between 18 years and 64 years – a time when early screening for cardiovascular disease would be important,” says lead author and Mayo Clinic OB-GYN Shannon Laughlin-Tommaso, M.D., “We wanted to do this study to find a gynecologic screening method for cardiovascular disease.”
Using the Rochester Epidemiology Project, a medical records linkage system, experts studied all available records of women who underwent hysterectomy with ovarian conservation in Olmsted County, Minnesota, between 1965 and 2002. The researchers compared the cardiovascular risk factors and diseases of these women with randomly selected control women of the same age who had not undergone a hysterectomy. The odds ratio for hyperlipidemia, obesity and metabolic syndrome was slightly higher in the 3,816 women who underwent hysterectomy, compared to the 3,816 women in the control group.
Obesity was the risk factor most strongly associated with hysterectomy at all ages. Because obesity contributes to several key reasons for hysterectomy, including fibroids and uterine prolapse, treating obesity might not only improve cardiovascular health, but also may reduce the need for hysterectomy.
Other cardiovascular risk factors and disease were related to a woman’s age at hysterectomy. Stroke was much more common among women who underwent hysterectomy before age 35, compared with age-matched controls. Similarly, for women age 35 to 40, hypertension was more frequent among those who underwent hysterectomy. Women who underwent hysterectomy over age 50 did not show any significant increase in risk factors and were less likely to have had a stroke or congestive heart failure, compared with control women of the same age.
Experts encourage women undergoing a hysterectomy to speak to their physicians about cardiovascular risks and possible prevention in light of these findings.