Carotid intima-media thickness: a new marker of patients with uterine leiomyoma

Aksoy, Yüksel; Sivri, Nasır; Karaöz, Banu; Sayın, Cenk; Yetkın, Ertan

doi:10.1016/j.ejogrb.2014.01.005

Cited by 24 publications

(21 citation statements)

References 21 publications

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“…We recently confirmed earlier research demonstrating a high prevalence of hypertension in women with fibroids and showed that this association was independent of age, BMI, and African ancestry . Data regarding CVD risk factors other than hypertension in women with uterine fibroids are scarce and not adjusted for confounders . Therefore, we assessed the CVD risk profile in women with fibroids compared to controls, adjusting for known confounders.…”

Section: Introductionsupporting

confidence: 80%

“…Both are of monoclonal origin and the result of proliferation of smooth muscle cells. Hypertension may cause smooth muscle cell injury and cytokine release, promoting the proliferation of smooth muscle cells in the vascular wall as well as in the uterine wall . This proliferation can also be induced by other atherosclerotic risk factors, such hyperinsulinemia and upregulation of insulin‐like growth factor‐1 (IGF‐1), thereby connecting obesity, diabetes, and hypertension to uterine fibroids .…”

Section: Discussionmentioning

confidence: 99%

“…The majority reported a modest increase in fibroid prevalence with increasing BMI . Some authors suggested that other CVD risk factors, such as diabetes and lipid disorders, also increase the risk to develop uterine fibroids . Recently, Uimari et al reported a higher fibroid risk in women with metabolic syndrome, and with increasing low‐density lipoprotein and triglyceride levels.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6]14 Data regarding CVD risk factors other than hypertension in women with uterine fibroids are scarce and not adjusted for confounders. [10][11][12][15][16][17] Therefore, we assessed the CVD risk profile in women with fibroids compared to controls, adjusting for known confounders. In addition, asymptomatic organ damage is an important determinant of overall CVD risk, independent of the cardiovascular prediction score.…”

Section: Introductionmentioning

confidence: 99%

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The risk of hypertension and cardiovascular disease in women with uterine fibroids

Haan

Diemer

Woude

et al. 2018

J of Clinical Hypertension

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Women with fibroids have a notably high hypertension risk. However, adjusted data regarding other cardiovascular disease (CVD) risk factors are scarce. In this cross-sectional study, CVD risk factors, hemodynamic parameters, and asymptomatic organ damage were analyzed between women with uterine fibroids and controls in a multi-ethnic population. In total, 104 women with self-reported fibroids and 624 controls were included. Women with fibroids had significantly higher odds to have hypertension (OR 3.4; 95% CI 2.2-5.2), diabetes (1.7; 1.0-2.9), and hypercholesterolemia (1.8; 1.1-3.2). After adjustment for confounders, only the odds ratio for hypertension was significant (1.8; 1.1-3.1). Asymptomatic organ damage occurred significantly more often in women with fibroids (66.7%; 95% CI 55.8%-77.6% vs 42.9%; 38.0-47.8 in controls), especially in the younger age group (respectively 48.5%; 31.1%-65.9% vs 22.1%; 17.0-27.2). In this study, women with fibroids had a remarkably high hypertension risk compared to controls, with more asymptomatic organ damage, in particular young women.

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Section: Introductionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The risk of hypertension and cardiovascular disease in women with uterine fibroids

Haan

Diemer

Woude

et al. 2018

J of Clinical Hypertension

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“…39 Finally, carotid intimal thickness, a predictor of atherosclerosis, was significantly elevated in non-obese women with leiomyomas compared with age-matched controls. 40 Thus, we hypothesized that women who underwent hysterectomy with ovarian conservation for leiomyomas would have higher cardiovascular risk factors. Despite the biological plausibility, we found no significant association of the leiomyoma indication with hypertension or CVD conditions, and obesity was similarly associated across all three groups of indications.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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Objective To study the association of preexisting cardiovascular risk factors and diseases in women who underwent hysterectomy with bilateral ovarian conservation compared with controls. Methods Using the Rochester Epidemiology Project records-linkage system, we identified all Olmsted County, Minnesota women who underwent hysterectomy with ovarian conservation between January 1, 1965 and December 31, 2002 (cases). Each case was aged-matched (±1 year) to a woman selected randomly who resided in the county and did not undergo hysterectomy or oophorectomy prior to the index date (date of hysterectomy in her matched case). Using electronic codes, we identified cardiovascular risk factors (diabetes, hypertension, hyperlipidemia, obesity, metabolic syndrome, and polycystic ovarian syndrome) and diseases (coronary artery disease, congestive heart failure, myocardial infarction, and stroke) that occurred before the index date. Analyses were stratified by age at hysterectomy and surgical indication. Results During the study period, 3,816 women underwent hysterectomy with ovarian conservation for a benign indication. Preexisting hyperlipidemia, obesity, and metabolic syndrome were significantly more frequent in cases than controls in univariable analyses. Obesity remained significantly associated in multivariable analyses overall, for nearly all age groups, and across all indications. Stroke was significantly more frequent in cases than controls in the women <36 years. Congestive heart failure and stroke were significantly less common in cases than controls in the women >50 years. Conclusions Hysterectomy with ovarian conservation is associated with cardiovascular risk factors, particularly obesity. Obesity may contribute to the underlying gynecologic conditions leading to hysterectomy; however, surgical selection may also play a role.

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Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife

Mitro,

Wise,

Waetjen

et al. 2024

JAMA Netw Open

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ImportanceFibroids are benign neoplasms associated with severe gynecologic morbidity. There are no strategies to prevent fibroid development.ObjectiveTo examine associations of hypertension, antihypertensive treatment, anthropometry, and blood biomarkers with incidence of reported fibroid diagnosis in midlife.Design, Setting, and ParticipantsThe Study of Women’s Health Across the Nation is a prospective, multisite cohort study in the US. Participants were followed-up from enrollment (1996-1997) through 13 semiannual visits (1998-2013). Participants had a menstrual period in the last 3 months, were not pregnant or lactating, were aged 42 to 52 years, were not using hormones, and had a uterus and at least 1 ovary. Participants with prior fibroid diagnoses were excluded. Data analysis was performed from November 2022 to February 2024.ExposuresBlood pressure, anthropometry, biomarkers (cholesterol, triglycerides, and C-reactive protein), and self-reported antihypertensive treatment at baseline and follow-up visits were measured. Hypertension status (new-onset, preexisting, or never [reference]) and hypertension treatment (untreated, treated, or no hypertension [reference]) were categorized.Main Outcomes and MeasuresParticipants reported fibroid diagnosis at each visit. Discrete-time survival models estimated hazard ratios (HRs) and 95% CIs for associations of time-varying hypertension status, antihypertensive treatment, anthropometry, and biomarkers with incident reported fibroid diagnoses.ResultsAmong 2570 participants without a history of diagnosed fibroids (median [IQR] age at screening, 45 [43-48] years; 1079 [42.1%] college educated), 526 (20%) reported a new fibroid diagnosis during follow-up. Risk varied by category of hypertension treatment: compared with those with no hypertension, participants with untreated hypertension had a 19% greater risk of newly diagnosed fibroids (HR, 1.19; 95% CI, 0.91-1.57), whereas those with treated hypertension had a 20% lower risk (HR, 0.80; 95% CI, 0.56-1.15). Among eligible participants with hypertension, those taking antihypertensive treatment had a 37% lower risk of newly diagnosed fibroids (HR, 0.63; 95% CI, 0.38-1.05). Risk also varied by hypertension status: compared with never-hypertensive participants, participants with new-onset hypertension had 45% greater risk of newly diagnosed fibroids (HR, 1.45; 95% CI, 0.96-2.20). Anthropometric factors and blood biomarkers were not associated with fibroid risk.Conclusions and RelevanceParticipants with untreated and new-onset hypertension had increased risk of newly diagnosed fibroids, whereas those taking antihypertensive treatment had lower risk, suggesting that blood pressure control may provide new strategies for fibroid prevention.

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Carotid intima-media thickness: a new marker of patients with uterine leiomyoma

Cited by 24 publications

References 21 publications

The risk of hypertension and cardiovascular disease in women with uterine fibroids

The risk of hypertension and cardiovascular disease in women with uterine fibroids

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

Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife

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