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Journal of the American College of Cardiology

Clinical Articles, Lead Article

Hysterectomy does not increase risk of CVD

Having a hysterectomy with or without ovary removal in mid-life does not increase a woman’s risk of cardiovascular disease (CVD) compared to women who reach natural menopause, contrary to many previously reported studies, according to a study published recently online1 by the Journal of the American College of Cardiology.

Investigators followed 3,302 premenopausal women between the ages of 42–52 for 11 years, who were enrolled in the Study of Women’s Health across the Nation (SWAN).  Researchers compared CVD risk factors in women prior to and following elective hysterectomy with or without ovary removal to the risk factors prior to and following final menstrual period in women who underwent natural menopause.

They found that several CVD risk factor changes differed prior to and following hysterectomy, compared to changes prior to and following a natural menopause, but those changes did not suggest an increased CVD risk following hysterectomy, independent of body mass index, which did increase after hysterectomy with removal of ovaries. These effects were similar in all ethnic groups in the study.

“Middle-aged women who are considering hysterectomy should be encouraged because our results suggest that increased levels of cardiovascular risk factors are not any more likely after hysterectomy relative to after natural menopause,” said lead author Professor Karen A Matthews, (University of Pittsburgh, Pennsylvania, USA).

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Professor Karen A Matthews (University of Pittsburgh, USA)

Professor Matthews said it is unclear why this study’s findings differed from other studies exploring hysterectomy and cardiovascular risk, but likely factors include the age of participants since hysterectomy that occurs earlier in life may present more cardiovascular risk. Also, earlier studies included women who had hysterectomy for any reason, whereas the SWAN study excluded women who had hysterectomy because of cancers, she added.

“This study will prove very reassuring to women who have undergone hysterectomy,” said American College of Cardiology CardioSmart Chief Medical Expert Dr JoAnne Foody. “As with anything, if a woman is concerned about her risk for heart disease she should discuss this with her health care provider.”

References

1. Matthews KA, Gibson CJ, El Khoudary SR, Thurston RC. Changes in cardiovascular risk factors by hysterectomy status with and without oophorectomy: study of women’s health across the nation. J Am Coll Cardiol 2013. http://dx.doi.org/10.1016/j.jacc.2013.04.042

Published on: May 22, 2013

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