Cardiovascular risk factors and diseases in women undergoing hysterectomy with ovarian conservation

Laughlin-Tommaso, Shannon K.; Khan, Zaraq; Weaver, Amy L.; Schleck, Cathy D.; Rocca, Walter A.; Stewart, Elizabeth A.

doi:10.1097/gme.0000000000000506

Cited by 33 publications

(33 citation statements)

References 40 publications

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“…Estrogen deficiency after menopause has been reported to be associated with adverse levels of CVDRF in women 27–29 . Evidence from experimental studies suggests that reduced estrogen levels may directly or indirectly contribute to diastolic dysfunction and hypertensive heart diseases in postmenopausal women 30, 31 .…”

Section: Discussionmentioning

confidence: 99%

The association of surgical versus natural menopause with future left ventricular structure and function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

et al. 2017

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OBJECTIVE Evaluate the association between surgical (SM) versus natural menopause (NM) in relation to later left ventricular (LV) structure and function, while taking into account the LV parameters and other cardiovascular disease risk factor (CVDRF) levels that predates the menopausal transition. METHODS We studied 825 premenopausal women from the CARDIA study in 1990–1991 (baseline, mean age: 32 years) who later reached menopause by 2010–2011 and had echocardiograms at these two time points. RESULTS During 20 years of follow up, 508 women reached NM while 317 underwent SM (34% had bilateral oophorectomy (BSO)). At baseline, women who later underwent SM were more likely to be black, younger, have greater parity and higher mean values of systolic blood pressure, body mass index as well as lower mean HDL cholesterol and physical activity than women who reached NM. No significant differences in LV structure/function were found between groups. In 2010–2011, SM women had significantly higher LV mass, LV mass/volume ratio, E/e′ ratio, and impaired longitudinal and circumferential strain than NM women. SM women with BSO had adverse LV measures than women with hysterectomy with ovarian conservation. Controlling for baseline echocardiographic parameters and CVDRF in linear regression models eliminated these differences between groups. Further adjustment for age at menopause/surgery and hormone therapy use did not change these results. CONCLUSION In this study, the adverse LV structure and function observed among women with SM compared to NM were explained by their unfavorable presurgical CVDRF profiles, suggesting that premenopausal CVDRF rather than gynecologic surgery predispose SM women to elevated future cardiovascular disease risk.

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Section: Discussionmentioning

confidence: 99%

The association of surgical versus natural menopause with future left ventricular structure and function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

et al. 2017

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“…The women who underwent hysterectomy with ovarian conservation were derived from a separate cohort study described elsewhere. 31 All analyses were completed using SAS statistical software version 9.4 (SAS Institute) and R statistical software version 3.1.1 (R Foundation for Statistical Computing), and tests of statistical significance were conducted at the 2-tailed α level of .05.…”

Section: Methodsmentioning

confidence: 99%

Accelerated Accumulation of Multimorbidity After Bilateral Oophorectomy: A Population-Based Cohort Study

Rocca

Gazzuola-Rocca

Smith

et al. 2016

Mayo Clinic Proceedings

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174

194

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Objective To study the association between bilateral oophorectomy and the rate of accumulation of multimorbidity. Patients and Methods In this historical cohort study, the Rochester Epidemiology Project records-linkage system was used to identify all premenopausal women who underwent bilateral oophorectomy before age 50 years between January 1, 1988, and December 31, 2007, in Olmsted County, Minnesota. Each woman was randomly matched to a referent woman born in the same year (± 1 year) who had not undergone bilateral oophorectomy. We studied the rate of accumulation of 18 common chronic conditions over a median of approximately 14 years of follow-up. Results Although women who underwent bilateral oophorectomy already had a higher multimorbidity burden at the time of oophorectomy, they also experienced a significantly increased risk of subsequent multimorbidity (P=.XX). After adjustments for 18 chronic conditions present at baseline, race/ethnicity, education, body mass index, smoking, age at baseline, and calendar year at baseline, women who underwent oophorectomy before age 46 years experienced an increased risk of depression, hyperlipidemia, cardiac arrhythmias, coronary artery disease, arthritis, asthma, chronic obstructive pulmonary disease, and osteoporosis. In addition, they experienced an accelerated rate of accumulation of the 18 chronic conditions considered together (hazard ratio, 1.22; 95% CI, 1.14–1.31; P<.001). Several of these associations were reduced in women who received estrogen therapy. Conclusion Bilateral oophorectomy is associated with a higher risk of multimorbidity, even after adjustment for conditions present at baseline and for several possible confounders. However, several of these associations were reduced in women who received estrogen therapy.

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“…In a population-based case-control study, hypertension was not higher preoperatively among women undergoing hysterectomy for UL compared with aged-matched referents [199]. However, all but two of these studies [156, 196] were limited to surgical cases of UL.…”

Section: Etiologic Hypotheses and Risk Factorsmentioning

confidence: 99%

Epidemiology of Uterine Fibroids

Wise

Laughlin-Tommaso

2016

Clinical Obstetrics &Amp; Gynecology

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261

122

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Uterine leiomyomata (UL) have a substantial impact on women's health, but relatively few studies have identified opportunities for primary prevention of these neoplasms. Most established risk factors are not modifiable, including premenopausal age, African ancestry, age at menarche, and childbearing history. The main challenge in studying UL is that a large proportion of tumors are asymptomatic. Herein, we review the epidemiology of UL from published studies to date. We highlight the advantages of ultrasound screening studies and the ways in which their innovative methods have helped clarify the etiology of disease. We conclude with a discussion of promising new hypotheses.

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Cardiovascular risk factors and diseases in women undergoing hysterectomy with ovarian conservation

Cited by 33 publications

References 40 publications

The association of surgical versus natural menopause with future left ventricular structure and function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

The association of surgical versus natural menopause with future left ventricular structure and function: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Accelerated Accumulation of Multimorbidity After Bilateral Oophorectomy: A Population-Based Cohort Study

Epidemiology of Uterine Fibroids

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