Untreated, new-onset hypertension tied to uterine fibroids in midlife
Click Here to Manage Email Alerts
Key takeaways:
- Untreated hypertension vs. no hypertension increased risk for newly diagnosed fibroids.
- Among women with hypertension, use of blood pressure medications was linked to lower risk for newly diagnosed fibroids.
NEW ORLEANS — Both new-onset and ongoing untreated hypertension were associated with increased risks for newly diagnosed uterine fibroids among midlife women, according to findings presented at the ASRM Scientific Congress & Expo.
“There’s some evidence that aldosterone-angiotensin led to fibroid cell proliferation, and there’s also some epidemiologic evidence connecting hypertension, or high blood pressure, with fibroids,” Susanna D. Mitro, PhD, research scientist in the division of research at Kaiser Permanente, said during the presentation.
Mitro and colleagues evaluated data from 2,570 women (mean age, 45 years; 49% white) from the Study of Women’s Health Across the Nation (SWAN), a multisite cohort study who did not have a history of uterine fibroids at baseline. The SWAN researchers measured BP, anthropometry and biomarkers at baseline and during follow-up visits. Mitro and colleagues used the data to examine associations of hypertension, antihypertensive treatment and CV risk factors with uterine fibroid diagnosis incidence in midlife.
Researchers defined hypertension duration using current and prior follow-up visit hypertension status and defined hypertension control using current follow-up visit BP and antihypertensive treatment. In addition, researchers estimated antihypertensive treatment effect for participants with hypertension.
Overall, 20% of participants reported a new uterine fibroids diagnosis during follow-up. Uterine fibroid risk varied by hypertension control.
Participants with untreated hypertension had an 18% greater risk for newly diagnosed uterine fibroids compared with participants without hypertension. Women with hypertension who used antihypertensive medications had a 37% lower risk for newly diagnosed uterine fibroids, and women using angiotensin-converting enzyme (ACE) inhibitors had a 48% lower risk compared with women who did not use antihypertension medications.
Women with new-onset hypertension had a 45% greater risk for newly diagnosed uterine fibroids compared with women without hypertension. But, researchers observed, women with preexisting hypertension had little risk for newly diagnosed uterine fibroids (HR = 1.05; 95% CI, 0.83-1.32).
Researchers also found that anthropometric factors and blood biomarkers were not substantially associated with risk for newly diagnosed uterine fibroids.
“These results suggest that blood pressure control could suggest an opportunity to prevent clinically apparent fibroid development in midlife, which is a high-risk time for fibroids to become clinically apparent.” Mitro said. “The ACE inhibitor findings in particular offers some potential insight into etiology, which I hope to follow up in future research.”