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Hysterectomy under age 50 increases risk of heart disease

22 Feb 2011

A Swedish study recently reported in European Heart Journal, has shown that women under the age of 50 undergoing hysterectomy, with or without oophorectomy (removal of ovaries) are at an increased risk of heart disease. Since hysterectomy is a very common procedure and cardiovascular disease is the biggest cause of death in women after the menopause, these results carry huge importance.

All Swedish women having a hysterectomy between 1973 and 2003 were identified and followed up. 184,441 such women were compared with 640,043 control women who had not had a hysterectomy. Data was obtained from hospital information related to hospitalization for cardiovascular disease.

Results showed that women below age 50 at the time of hysterectomy had a significantly increased risk of cardiovascular disease during follow-up, which applied to both coronary heart disease as well as stroke, and was still evident after adjusting for socio-economic status. The risk was further increased in women who also had oophorectomy . There was no association between hysterectomy and cardiovascular disease in women having hysterectomy aged 50 and above.

It is believed that premenopausal removal of the ovaries, leading to early lack of estrogen, causes the increase in cardiovascular risk and indeed, it is known that untreated natural premature menopause significantly increases cardiovascular risk. Heart disease risk increasing in young women having a hysterectomy alone could be explained by the procedure affecting the blood supply to the ovaries, leading to early ovarian failure and hormone effects on the cardiovascular system.

Although large numbers, limitations are that this study is observational and relies on hospital data, possibly missing cardiovascular events which did not require hospitalization. However, these important findings should be considered when discussing the benefits and risks of hysterectomy in young women.

[Reference]

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