Evaluation of Cardiovascular Risk Factors in Women with Uterine Leimyomata: Is there a Link with Atherosclerosis?

Abstract

Objective: Both uterine leimyoma (UL) and cardiovascular disease are public health problems affecting women at different age ranges. Smoking, obesity, and hypertension have been shown to be associated with UL in different random studies. However cardiovascular risk factors have not been evaluated systematically in patients with UL. Accordingly, we aimed to evaluate the cardiovascular risk factors and their relation with the presence of UL.Material and Methods: One hundred and eighty nine patients with the pathological diagnosis of UL and one hundred and eighty nine age matched control subjects without UL were retrospectively included in the study from our data base of the pathology and gynecology departments. Controls were patients with intact uteri who had visited the same physicians for a routine checkup that included a pelvic examination and uterine sonogram and without mention of physical findings consistent with UL. The following clinical and demographic parameters were recorded; age, sex, hypertension, diabetes mellitus, and hypercholesterolemia. Current cigarette smoking was defined as active smoking within the past 12 months. Results:Comparison of cardiovascular risk factors between with and without UL revealed that the presence of hypertension (80 (42.3%) vs 53 (28%) p=0.004) diabetes mellitus (33 (17.4%) vs. 16 (8.4%) p=0.009), smoking (31 (16.4%) vs. 11 (5.8%) p=0.001), were significantly higher in patients with UL than in control subjects. The mean-age and presence of hyperlipidemia were comparable between the two groups. Logistic regression analysis revealed an independent and positive association of UL with the presence of hypertension (odds ratio 2.02 CI: 1.25-3.27 p=0.004), diabetes mellitus (odds ratio 2.43 CI: 1.23-4.79 p=0.010), and smoking status (odds ratio 3.46 CI: 1.65-7.22 p=0.001). Conclusion:We have shown that major cardiovascular risk factors namely, hypertension, diabetes mellitus and smoking are significantly and independently associated with UL. Our findings highlight the possible association of UL with atherosclerosis.

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

“…A small number of studies have evaluated the association between fibroids and hypertension with conflicting results. Some studies have reported that a history of fibroids was associated with hypertension and atherosclerosis, in line with our results [14,15,23]. In a Dutch cross-sectional study, women with surgically-treated fibroids had a higher hypertension prevalence compared with controls, independently from age and BMI [14].…”

“…As a result, the chronic systemic inflammation associated with endometriosis may predispose women with this disease to a higher risk of hypertension. Insulin resistance can also be involved as a common pathway between uterine fibroids and hypertension as hyperinsulinemia may elevate fibroid risk by stimulating uterine leiomyomata cell growth (14,15,23). Other mechanisms may also be involved.…”

“…Similarly, associations between non-malignant gynecological conditions, such as endometriosis and fibroids, and the risk of hypertension are unclear, and the confounding or mediating effects by other risk factors or by hysterectomy, frequent treatment of these diseases, are still unknown [11,[13][14][15][20][21][22][23]. Additional large cohort studies are warranted to confirm the association between these conditions and the risk of incident hypertension.…”

Between Uterine Fibroid and High Cardiovascular Risk in Premenopausal Women

“…Из бессимптомных поражений органов-мишеней нами выявлена только ГЛЖ, частота которой была статистически значимо выше в группе женщин с миомой. Это согласуется с данными китайского исследования, в котором зафиксированы значимо более высокий лодыжечно-плечевой индекс и тенденция к более высокой скорости пульсовой волны у женщин с миомой [22]. Однако в исследовании S.К.…”

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

“…31-35 These associations have biologic plausibility because hypertension, atherosclerosis, and leiomyomas may share similar mechanisms involving inflammatory pathways, vascular dysfunction, or plaque formation. 32, 36, 37, 38 .…”