Laughlin-Tommaso S, et al. - The long-term risk of cardiovascular disease and metabolic conditions was investigated in women undergoing hysterectomy with bilateral ovarian conservation compared with age-matched referent women. Hysterectomy was noted to be associated with an increased long-term risk of cardiovascular and metabolic conditions, especially in women who undergo hysterectomy at age ≤35 years even with ovarian conservation.

Methods

• Researchers identified 2,094 women who underwent hysterectomy with ovarian conservation for benign indications between 1980 and 2002 in Olmsted County, Minnesota, using the Rochester Epidemiology Project records-linkage system.
• They age-matched (±1 y) each woman to a referent woman residing in the same county who had not undergone prior hysterectomy or any oophorectomy.
• They followed the two cohorts historically to identify de novo cardiovascular or metabolic diagnoses.
• Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models adjusted for 20 preexisting chronic conditions and other potential confounders.
• Calculation of absolute risk increases and reductions from Kaplan–Meier estimates was also performed.

Results

• Women who underwent hysterectomy experienced increased risks of de novo hyperlipidemia (HR 1.14; 95% CI, 1.05-1.25), hypertension (HR 1.13; 95% CI, 1.03-1.25), obesity (HR 1.18; 95% CI, 1.04-1.35), cardiac arrhythmias (HR 1.17; 95% CI, 1.05-1.32), and coronary artery disease (HR 1.33; 95% CI, 1.12-1.58) over a median follow-up of 21.9 years.
• Hysterectomy performed on women at age ≤35 years led to a 4.6-fold increased risk of congestive heart failure and a 2.5-fold increased risk of coronary artery disease.