A 10-year study of more than 2.7 million U.S. women has found that those diagnosed with uterine fibroids face more than 80% higher long-term risk for cardiovascular disease compared to women without fibroids. The research, published in the Journal of the American Heart Association, suggests fibroids may serve as an important marker for identifying women at elevated cardiovascular risk, with sustained increased risk persisting up to 10 years after diagnosis.

Uterine fibroids are predominately benign growths that develop from the muscle tissue of the uterus. According to the U.S. Office of Women's Health, as many as 20% to 80% of women will develop fibroids by age 50, with nearly 26 million pre-menopausal women in the U.S. impacted. Despite this high prevalence, fibroids remain understudied and poorly understood, according to study author Julia D. DiTosto, a Ph.D. Candidate in Epidemiology at the University of Pennsylvania's Perelman School of Medicine.

"Some studies have shown that fibroids and cardiovascular disease share biological pathways, including the growth of smooth muscle cells, the excessive buildup of fibrous connective tissue, calcification and inflammatory responses," DiTosto noted. "Our findings suggest that fibroids may serve as an important marker for identifying women at elevated cardiovascular risk."

The study analyzed health information from 2000 to 2022, comparing more than 450,000 women with fibroids to nearly 2.25 million women without fibroids. Researchers monitored for incidences of coronary artery disease, cerebrovascular disease including stroke, and peripheral artery disease over the following decade.

Key findings revealed that after 10 years of follow-up, women with fibroids were at higher risk for all three major cardiovascular conditions. The overall risk of developing cardiovascular disease was 81% higher among women with fibroids compared to those without. At the 10-year mark, more than 5.4% of women with fibroids had experienced a cardiovascular event compared to 3% of women without fibroids.

The elevated heart disease risk persisted among all racial and ethnic groups but was particularly strong in women younger than 40. Among this younger demographic, the risk for cardiovascular disease was 251% higher in those with fibroids compared to those without fibroids.

"The strength of the relationship between heart disease risk and uterine fibroids was striking," DiTosto said. "However, it's important to note that more research is needed to confirm these findings in other populations before formal changes are made to cardiovascular risk assessment guidelines."

Stacey E. Rosen, M.D., volunteer president of the American Heart Association, emphasized the broader implications: "This study highlights yet another aspect in the unique factors that impact women in regard to the leading cause of death among them - cardiovascular disease. Because many women may use annual 'well-woman' visits to their gynecologist or their general practitioner as their primary point of care, these visits offer exceptional opportunities that go beyond gynecologic health."

The study's limitations include the possibility that fibroids may not have been diagnosed yet in women included in the comparison group. While researchers attempted to account for possible underdiagnosis, this limitation may have impacted results to some extent. The research team adjusted for numerous factors including sociodemographic characteristics, cardiovascular risk factors, mental health conditions, reproductive history, and medication use.

These findings support having thoughtful conversations between women and their healthcare providers about heart health in the context of a fibroid diagnosis, particularly since many women with fibroids experience no symptoms. The connection suggests that routine gynecological care could play a crucial role in early cardiovascular risk identification and prevention strategies for millions of women.

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