Study Finds Uterine Fibroids Associated with 80% Higher Heart Disease Risk in Women

Long-term heart disease risk among women diagnosed with uterine fibroids was more than 80% higher than in women without uterine fibroids, according to a 10-year study of more than 2.7 million U.S. women published in the Journal of the American Heart Association. The elevated heart disease risk among those with uterine fibroids persisted among all races and ages but was particularly strong in women younger than 40, where the risk was 251% higher. Researchers said more studies are needed to better understand and confirm the relationship between having uterine fibroids and increased heart disease risk, but these findings suggest women diagnosed with fibroids may benefit from enhanced attention to heart health and risk factor management.

Fibroids are predominately 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% to 80% of women will develop fibroids by age 50. Study author Julia D. DiTosto, a Ph.D. Candidate in Epidemiology at the University of Pennsylvania, explained that nearly 26 million pre-menopausal women in the U.S. are impacted by uterine fibroids, yet despite the high prevalence, fibroids remain understudied. Some studies have shown that fibroids and cardiovascular disease share biological pathways, including the growth of smooth muscle cells, 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 females with fibroids compared to nearly 2.25 million females without fibroids. Over the next decade, researchers monitored for incidences of coronary artery disease, cerebrovascular disease and peripheral artery disease. They found that 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 those 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.

Women diagnosed with uterine fibroids were at increased heart disease risk across all racial and ethnic groups. DiTosto noted that the strength of the relationship between heart disease risk and uterine fibroids was striking, but emphasized 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, stated that this study highlights yet another aspect in the unique factors that impact women in regard to the leading cause of death among them. Because many women may use annual well-woman visits to their gynecologist or general practitioner as their primary point of care, these visits offer exceptional opportunities that go beyond gynecologic health. These findings linking fibroids to heart disease support the need to discuss the bigger picture that considers ways to identify and reduce cardiovascular disease risk, even among those women who may not have any other apparent risk factors.

Among the limitations of the study, fibroids may not have been diagnosed yet in women included in the comparison group. While the researchers tried to account for possible underdiagnosis of fibroids, this limitation may have impacted the results to some extent. The study included 2.7 million females with an average age of 41 years, using data from Optum's de-identified Clinformatics Data Mart Database. Models adjusted for sociodemographic factors, cardiovascular risk factors, mental health conditions, reproductive history, cancer, health care utilization and medication use. The findings suggest that 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.