Background: Uterine fibroids, the most common reproductive tract tumor in women, have been associated with hypertension and atherosclerotic cardiovascular disease (CVD). Prior studies of fibroids and CVD have examined the subset of women with symptomatic fibroids who undergo hysterectomy, itself a risk factor for CVD. We aimed to study the risk of subclinical CVD, as determined by coronary artery calcification (CAC), carotid intima media thickness (CIMT), and left ventricular (LV) mass, in women with ultrasound-diagnosed uterine fibroids. Materials and Methods: Participants were 972 women from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort recruited in 1985-1986. CARDIA screened black and white women aged 35-49 years by ultrasound for fibroids at 16 years of follow-up (2002-2004). Demographics and CVD risk factors were collected in 2000-2001 at 15 years of follow-up (baseline for this analysis). Women were tested at years 15, 20, and 25 for CAC, at year 20 for CIMT, and at year 25 for echocardiographic LV mass. Multivariable logistic regression was used to estimate the odds of CAC, CIMT, and LV mass. Results: Fifty-two percent of women had fibroids (61.7% in black, 38.3% in white women). Most CVD risk factors were more common in women with fibroids. Adjusted odds of subclinical CVD, such as elevated CIMT and elevated LV mass, were not different for women with fibroids compared with those without (CIMT odds ratio [OR] = 1.03; confidence interval [95% CI] 0.7-1.5 and LV mass OR = 1.14; 95% CI 0.77-1.68), when adjusted for confounders. Conclusions: Although women with fibroids had more CVD risk factors, presence of fibroids was not associated with subclinical CVD.
Bibliographical noteFunding Information:
We thank the participants and staff of the CARDIA study for making this research possible. The Coronary Artery Risk Development in Young Adults study (CARDIA) is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201300025C and HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota (HHSN 268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine (HHSN268200900041C). The CARDIA Women’s study was supported by the National Heart, Lung, and Blood Institute (R01-HL065611). CARDIA is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005). This article has been reviewed by CARDIA for scientific content. Dr. Fuchs was previously supported by an institutional training grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (T32HD055163, PI: AB Berenson). Dr. Fuchs is supported by a research career development award (K12HD052023: Building Interdisciplinary Research Careers in Women’s Health-BIRCWH; A.B. Berenson, PI) from the Office of Research on Women’s Health and the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the NIH. Dr. S.K.L. was supported by a research career development award (K12HD065987: Building Interdisciplinary Research Careers in Women’s Health-BIRCWH). Drs. S.K.L. and E.A.S. were supported by the Eunice Kennedy Shriver National Institute of Child and Health and Human Development (R01 HD060503).
S.K.L. reports personal fees from Allergan, grants from Halt Medical, outside of the submitted work; P.J.S. reports grants from University of Minnesota during the conduct of the study; E.A.S. reports personal fees from AbbVie, Allergan, Astellas, Bayer, GlaxoSmithKline, Gynesonics, Myo-vant, and Welltwigs from outside of the submitted work; C.E.L. reports grants from NIH during the conduct of the study. All other authors have nothing to disclose.
© Copyright 2019, Mary Ann Liebert, Inc.
- Cardiovascular disease
- Carotid intima media thickness
- Coronary artery calcification