Long-term heart disease risk among women diagnosed with uterine fibroids was more than 80% higher than in women without fibroids, according to a 10-year study of more than 2.7 million U.S. women published today in the Journal of the American Heart Association. The elevated risk persisted among all races and ages but was particularly strong in women younger than 40, who faced a 251% higher risk.
Fibroids are predominantly benign growths that develop from the muscle tissue of the uterus. The U.S. Office of Women’s Health notes that as many as 20% – and possibly up to 80% – of women will develop fibroids by age 50.
“Nearly 26 million pre-menopausal women in the U.S. are impacted by uterine fibroids and many do not experience any symptoms. Yet despite the high prevalence, fibroids are understudied and poorly understood,” said study author Julia D. DiTosto, M.S., a Ph.D. Candidate in Epidemiology at the Perelman School of Medicine at the University of Pennsylvania. “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.”
Researchers analyzed a U.S. database of health information from 2000 to 2022, studying more than 450,000 women with fibroids compared to nearly 2.25 million women without fibroids. Over the next decade, they monitored for incidences of coronary artery disease (including heart attack), cerebrovascular disease (stroke and related conditions) and peripheral artery disease.
After 10 years of follow-up, women with fibroids were at higher risk for all three major conditions. The risk of developing cardiovascular disease was 81% higher among women with fibroids compared to those without. At 10 years, more than 5.4% of women with fibroids had experienced a cardiovascular event compared to 3% of women without fibroids. The increased risk was observed across all racial and ethnic groups, including white, Black, Hispanic and Asian women.
Among younger women under age 40, the risk for cardiovascular disease was 251% higher – more than 3.5 times more likely – in those with fibroids compared to those without. “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. In the meantime, these results support having thoughtful conversations between women and their providers about heart health in the context of a fibroid diagnosis.”
Stacey E. Rosen, M.D., volunteer president of the American Heart Association and senior vice president of women’s health at Northwell Health, commented: “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. It also is an opportunity to recognize the very important role all of a woman’s health care clinicians can play in her overall health, including heart health. 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.”
Study limitations include the possibility that fibroids may not have been diagnosed in the comparison group. Researchers adjusted for sociodemographic factors, cardiovascular risk factors, mental health conditions, and reproductive history. The study was published in the Journal of the American Heart Association and is available online.
