Hysterectomy with ovarian conservation linked to cardiovascular and metabolic risks

Takeaway

• Hysterectomy with bilateral ovarian conservation is associated with an increased risk for several cardiovascular and metabolic conditions.

Why this matters

• Earlier studies pertaining to hysterectomy with ovarian conservation had methodological limitations, most failing to control for pre-existing cardiovascular disease (CVD).
• The present study evaluates long-term risk for CVD and metabolic conditions post hysterectomy compared with the reference population.

Study design

• Women who underwent hysterectomy (n=2094; median age, 40 years) were compared with age-matched reference women.
• The median follow-ups were 22.5 years (hysterectomy group) and 21.3 years (reference group).
• Funding: The National Institute on Aging and others.

Key results

• Indications for hysterectomy with ovarian conservation included uterine leiomyomas (39.5%), prolapse (20.3%), menstrual disorders (25.5%) and others (14.7%).
• Compared with the reference group, those who underwent hysterectomy had significantly increased risks for:
  • Hyperlipidemia (aHR, 1.14; P=.002);
  • Hypertension (aHR, 1.13; P=.01);
  • Obesity (aHR, 1.18; P=.01);
  • Cardiac arrhythmias (aHR, 1.17; P=.006); and
  • Coronary artery disease (CAD; aHR, 1.33; P=.001).

• Hysterectomy at age ≤35 years was associated with a 4.6-fold increase in congestive heart failure, a 2.5-fold increase in CAD and a 1.4-fold increased risk for cardiac arrhythmias.

Limitations

• Observational study.