Cardiovascular mortality is higher in women than in men, and this difference is still increasing. The awareness about hypertension, the main risk factor of cardiovascular disease, is high. Nevertheless, still a large part of the women is not adequately controlled. It has not been established, whether uterine fibroids might be a new female-specific risk factor for hypertension. Therefore, we systematically reviewed the association between uterine fibroids and hypertension.
Design and method:
We systematically searched MEDLINE, EMBASE, CENTRAL, LILACS, and Google Scholar to identify studies on uterine fibroids and hypertension. The search was conducted with no restriction to language or publication date. Two reviewers independently extracted the data. The primary outcome was the prevalence of hypertension in women with and without uterine fibroids.
We retrieved 1,807 papers. Eleven observational studies met our inclusion criteria, which included a total of 2,219 women with and 9,995 women without fibroids. Ten of the eleven studies showed a positive association between fibroids and hypertension, resulting in a pooled odds ratio of 1.88 (95% CI: 1.44 to 2.46, p <0.001, Figure 1). Subgroup analyses revealed that the association between hypertension and fibroids was significant in women with observed hypertension as well as self-reported hypertension, with odds ratios of 1.90 (95% CI: 1.34 to 2.69) and 1.83 (95% CI: 1.16 to 2.89) respectively. Furthermore, both histopathologically confirmed fibroids and self-reported fibroids were associated with hypertension; odds ratios 1.90 (95% CI: 1.34 to 2.69) and 1.91 (95% CI: 1.18 to 3.10) respectively.
Uterine fibroids are associated with hypertension. More awareness about this association might reduce the gender gap in cardiovascular disease. Furthermore, more research is needed to explore the nature of this association.