A 10-year study of more than 2.7 million U.S. women has revealed that long-term heart disease risk among women diagnosed with uterine fibroids was more than 80% higher than in women without uterine fibroids. The research, published in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association, found the elevated heart disease risk persisted among all races and ages but was particularly strong in women younger than 40.
Researchers studied more than 450,000 females with fibroids compared to nearly 2,251,000 females without fibroids, monitoring for incidences of coronary artery disease, cerebrovascular disease, and peripheral artery disease over a decade. After 10 years of follow-up, women with fibroids were at higher risk for all three major conditions, with 5.4% of women with fibroids experiencing a cardiovascular event compared to 3% of women without fibroids.
"The strength of the relationship between heart disease risk and uterine fibroids was striking," said study author Julia D. DiTosto, M.S., a Ph.D. Candidate in Epidemiology at the Perelman School of Medicine at the University of Pennsylvania. "Our findings suggest that fibroids may serve as an important marker for identifying women at elevated cardiovascular risk, with sustained increased risk persisting up to 10 years after diagnosis."
The U.S. Office of Women's Health notes that as many as 20% - and possibly up to 80% - of women will develop fibroids by age 50, with nearly 26 million pre-menopausal women in the U.S. impacted. Despite this high prevalence, fibroids remain understudied and poorly understood. Some studies have shown that fibroids and cardiovascular disease share biological pathways, including the growth of smooth muscle cells, excessive buildup of fibrous connective tissue, calcification, and inflammatory responses.
Among younger women under age 40, the risk for cardiovascular disease was 251% higher in those with fibroids compared to those without. Women diagnosed with uterine fibroids were at increased heart disease risk across all racial and ethnic groups studied. The researchers used data from Optum's de-identified Clinformatics Data Mart Database, studying commercially insured individuals from 2000 to 2022.
"This study highlights yet another aspect in the unique factors that impact women in regard to the leading cause of death among them - cardiovascular disease," said Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association. "These findings linking fibroids to heart disease support the need to discuss the bigger picture that considers ways to identify and reduce cardiovascular disease risk, even among those women who may not have any other apparent risk factors."
Researchers noted that more studies are needed to better understand and confirm the relationship between having uterine fibroids and increased heart disease risk. For now, these findings suggest women diagnosed with fibroids may benefit from enhanced attention to heart health and risk factor management. The study's limitations include the possibility that fibroids may not have been diagnosed yet in women included in the comparison group, which may have impacted results to some extent.
