Early hysterectomy increases risk for cardiovascular disease

Early menopause due to hysterectomy is associated with increased risks for a composite of cardiovascular disease (CVD), according to a study published online June 12 in JAMA Network Open.

Jin-Sung Yuk, M.D., Ph.D., from the Inje University College of Medicine in Seoul, South Korea, and colleagues evaluated the association of hysterectomy with the risk for incident CVD among women (aged 40 to 49 years). The analysis included 55,539 pairs with and without hysterectomy matched for age, socioeconomic status, region, Charlson Comorbidity Index, hypertension, diabetes, dyslipidemia, menopause, menopausal hormone therapy, and adnexal surgery.

The researchers found that during a median 7.9 years of follow-up, the incidence of CVD was 115 per 100,000 person-years for the hysterectomy group versus 96 per 100,000 person-years for the no-hysterectomy group. The hysterectomy group had an increased risk for CVD compared with the no-hysterectomy group in an adjusted analysis (hazard ratio, 1.25).

While the groups were similar for the incidence of myocardial infarction and coronary artery revascularization, the risk for stroke was significantly higher in the hysterectomy group (hazard ratio, 1.31). Findings persisted even when excluding women who underwent oophorectomy.

"Although we found that widely performed hysterectomy with a broad indication for benign diseases at premenopausal ages slightly increases the risk of CVD, the incidence is not high, so a change in clinical practice may not be needed," the authors write.