A comprehensive 10-year study of more than 2.7 million U.S. women has revealed a significant association between uterine fibroids and substantially increased risk of cardiovascular disease, with women diagnosed with fibroids facing more than 80% higher long-term heart disease risk compared to those without the condition. Published in the Journal of the American Heart Association, the research indicates this elevated risk persists across all racial and ethnic groups but is particularly pronounced in women younger than 40, where the cardiovascular disease risk was 251% higher among those with fibroids.
Uterine fibroids are predominantly benign growths that develop from the muscle tissue of the uterus, affecting as many as 20% to 80% of women by age 50 according to the U.S. Office of Women’s Health. Despite their high prevalence, fibroids remain understudied, with nearly 26 million pre-menopausal women in the U.S. impacted, many without experiencing symptoms. "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," 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.
The research team analyzed health information from 2000 to 2022, comparing more than 450,000 women with fibroids to nearly 2.25 million women without the condition. Over the following 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 cardiovascular conditions, with 5.4% of women with fibroids experiencing a cardiovascular event compared to 3% of women without fibroids.
"The strength of the relationship between heart disease risk and uterine fibroids was striking," DiTosto noted, adding 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. However, she emphasized that more research is needed to confirm these findings in other populations before formal changes are made to cardiovascular risk assessment guidelines.
Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association, highlighted the significance of these findings for women's health care. "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," Rosen said. "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."
The study's limitations include the possibility that fibroids may not have been diagnosed yet in women included in the comparison group, which could have impacted results to some extent. Researchers adjusted for numerous factors including sociodemographic characteristics, cardiovascular risk factors, mental health conditions, reproductive history, and medication use. The findings suggest women diagnosed with fibroids may benefit from enhanced attention to heart health and risk factor management, supporting the need for comprehensive discussions between women and their health care providers about cardiovascular risk in the context of a fibroid diagnosis.
