Early hysterectomy poses increased CVD risk

Undergoing early hysterectomy appears to put women at heightened risk of a composite of cardiovascular disease (CVD), especially stroke, as reported in a study.

For the study, a total of 135,575 women aged 40–49 years underwent evaluation. Researchers performed propensity score matching according to covariates such as age, socioeconomic status, region, Charlson Comorbidity Index, hypertension, diabetes, dyslipidaemia, menopause, menopausal hormone therapy, and adnexal surgery. 

After matching, a total of 55,539 pairs (median age 45 years) were included in the hysterectomy and nonhysterectomy groups for analysis. The primary endpoint was incident CVD, which was a composite of myocardial infarction, coronary artery revascularization, and stroke.

Over a median follow-up of 7.9 years overall, CVD incidence rates were 115 per 100,000 person-years for the hysterectomy group and 96 per 100,000 person-years for the nonhysterectomy group. Multivariable Cox analysis showed that hysterectomy was associated with a 25-percent increase in the risk of CVD (hazard ratio [HR], 1.25, 95 percent confidence interval [CI], 1.09–1.44).

When the individual components were analysed, only the risk of stroke appeared to be elevated in the hysterectomy group (HR, 1.31, 95 percent CI, 1.12–1.53).

Finally, in an analysis that excluded women who underwent oophorectomy, hysterectomy showed a consistent association with the risk of CVD (HR, 1.24, 95 percent CI, 1.06–1.44).