The risk of heart disease is known to be higher among postmenopausal women. A new study from South Korea has shown that women who had a hysterectomy done before 50 years of age were at a higher risk for heart disease, stroke in particular. The study findings are published in JAMA Network Open.¹

Jin-Sung Yuk from the Dept. of Obstetrics and Gynecology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea and coresearchers conducted this retrospective study to examine if hysterectomy before age 50 years increased the risk of new onset cardiovascular disease (CVD). For this they sourced data of 55,539 women who underwent a hysterectomy, with a median age of 45 years, from the national health insurance database from January 2011 to December 2014 and matched them with 55,539 women, who did not undergo a hysterectomy.

Over nearly 8 years (median) of follow-up, the hysterectomy group had a greater risk of CVD with the incidence of heart disease being 115 per 100 000 person-years compared with 96 per 100 000 person-years in the non-hysterectomy group. After adjustment for multiple variables, women who underwent hysterectomy were at a higher risk of developing heart disease compared to those who did not have the surgery with hazard ratio (HR) of 1.25. The risk of stroke was found to be significantly increased among women in the hysterectomy group with HR of 1.31. But the occurrence of MI (HR 1.06) and coronary artery revascularization (HR 1.03) were similar between both groups. When women who also had an oophorectomy were excluded from the analysis, the risk of heart disease was still higher in women with hysterectomy (HR 1.24).

These findings suggest that hysterectomy in women younger than 50 years resulting in early menopause is associated with increased risk of heart disease, especially stroke. The authors write that “because the incidence of CVD was not high, a change in clinical practice may not be needed”. Nevertheless, women undergoing early hysterectomy should be educated about the risk of heart disease and recommended a healthy lifestyle to prevent a cardiovascular event.

Reference

1. Jin-Sung Yuk, et al. Association of early hysterectomy with risk of cardiovascular disease in Korean women. JAMA Netw Open. 2023 Jun 1;6(6):e2317145. doi: 10.1001/jamanetworkopen.2023.17145.