Uterine Fibroids and the Risk of Cardiovascular Disease in the Coronary Artery Risk Development in Young Adult Women's Study

Shannon K. Laughlin-Tommaso; Erika L. Fuchs; Melissa F. Wellons; Cora E. Lewis; Ronit Calderon-Margalit; Elizabeth A. Stewart; Pamela J. Schreiner

doi:10.1089/jwh.2018.7122

Uterine Fibroids and the Risk of Cardiovascular Disease in the Coronary Artery Risk Development in Young Adult Women's Study

Shannon K. Laughlin-Tommaso^*, Erika L. Fuchs, Melissa F. Wellons, Cora E. Lewis, Ronit Calderon-Margalit, Elizabeth A. Stewart, Pamela J. Schreiner

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

Abstract

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.

Original language	American English
Pages (from-to)	46-52
Number of pages	7
Journal	Journal of Women's Health
Volume	28
Issue number	1
DOIs	https://doi.org/10.1089/jwh.2018.7122
State	Published - Jan 2019
Externally published	Yes

Bibliographical note

Funding 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).

Funding Information:
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.

Publisher Copyright:
© Copyright 2019, Mary Ann Liebert, Inc.

Keywords

Cardiovascular disease
Carotid intima media thickness
Coronary artery calcification
Fibroids
Hysterectomy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1089/jwh.2018.7122

Cite this

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title = "Uterine Fibroids and the Risk of Cardiovascular Disease in the Coronary Artery Risk Development in Young Adult Women's Study",

abstract = "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.",

keywords = "Cardiovascular disease, Carotid intima media thickness, Coronary artery calcification, Fibroids, Hysterectomy",

author = "Laughlin-Tommaso, {Shannon K.} and Fuchs, {Erika L.} and Wellons, {Melissa F.} and Lewis, {Cora E.} and Ronit Calderon-Margalit and Stewart, {Elizabeth A.} and Schreiner, {Pamela J.}",

note = "Funding 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{\textquoteright}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{\textquoteright}s Health-BIRCWH; A.B. Berenson, PI) from the Office of Research on Women{\textquoteright}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{\textquoteright}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). Funding Information: 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. Publisher Copyright: {\textcopyright} Copyright 2019, Mary Ann Liebert, Inc.",

year = "2019",

month = jan,

doi = "10.1089/jwh.2018.7122",

language = "American English",

volume = "28",

pages = "46--52",

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T1 - Uterine Fibroids and the Risk of Cardiovascular Disease in the Coronary Artery Risk Development in Young Adult Women's Study

AU - Laughlin-Tommaso, Shannon K.

AU - Fuchs, Erika L.

AU - Wellons, Melissa F.

AU - Lewis, Cora E.

AU - Calderon-Margalit, Ronit

AU - Stewart, Elizabeth A.

AU - Schreiner, Pamela J.

N1 - Funding 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). Funding Information: 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. Publisher Copyright: © Copyright 2019, Mary Ann Liebert, Inc.

PY - 2019/1

Y1 - 2019/1

N2 - 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.

AB - 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.

KW - Cardiovascular disease

KW - Carotid intima media thickness

KW - Coronary artery calcification

KW - Fibroids

KW - Hysterectomy

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IS - 1

ER -

Uterine Fibroids and the Risk of Cardiovascular Disease in the Coronary Artery Risk Development in Young Adult Women's Study

Abstract

Bibliographical note

Keywords

UN SDGs

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