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Hysterectomy, non-malignant gynecological diseases, and the risk of incident hypertension: The E3N prospective cohort

      Highlights

      • In this study, hysterectomy, with or without oophorectomy, was associated with an increased risk of hypertension.
      • Endometriosis was associated with an increased risk of hypertension.
      • A history of uterine fibroids was associated with an increased risk of hypertension.
      • Associations between hypertension and non-malignant gynecological diseases were independent of a history of hysterectomy.

      Abstract

      Objectives

      While it has been reported that women with uterine fibroids or endometriosis are commonly overweight and hypertensive, the association between non-malignant gynecological diseases and the risk of hypertension has been little studied prospectively. The aim of this study was to investigate in a large French cohort of women whether a history of hysterectomy, uterine fibroids, or endometriosis was prospectively related to an increased risk of incident hypertension.

      Study design

      We analyzed 50,286 women from the E3N cohort who were free of hypertension at baseline, with a median follow-up of 16.4 years.

      Main outcome measures

      Gynecological diseases were based on self-report. Cox proportional hazards models with age as the timescale were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Covariates included smoking status, body mass index (BMI), physical activity, and hormonal factors.

      Results

      A total of 12,073 women (24%) developed hypertension during follow-up. Women with a history of hysterectomy had an increased risk of incident hypertension, which persisted after adjustment for potential confounding factors (adjusted HR=1.18, 95% CI 1.12–1.24). Risk was similar in women with hysterectomy with or without oophorectomy. Risk of hypertension was higher in women with a history of endometriosis (HRendometriosis 1.19, 95%CI 1.11–1.22) or uterine fibroids (HRfibroids 1.18, 95%CI 1.13–1.22), irrespective of hysterectomy. Associations were similar after further adjustment for BMI.

      Conclusions

      Hysterectomy and non-malignant gynecological diseases were associated with an increased risk of hypertension in this large prospective study. Women with these conditions may benefit from blood pressure monitoring.
      ClinicalTrials.gov identifier: NCT03285230

      Keywords

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