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Hysterectomy is associated with large artery stiffening in estrogen-deficient postmenopausal women

Gavin, Kathleen M. MS1,2; Jankowski, Catherine PhD1; Kohrt, Wendy M. PhD1; Stauffer, Brian L. MD3,4; Seals, Douglas R. PhD1,4; Moreau, Kerrie L. PhD1,4

doi: 10.1097/gme.0b013e31825040f9
Original Articles

Objective Hysterectomy, with or without oophorectomy, is associated with increased cardiovascular disease (CVD) risk due, in part, to an adverse CVD risk factor profile. Large artery stiffening, a biomarker of vascular aging, increases the risk for CVD. We determined whether hysterectomy with or without bilateral oophorectomy (BLO) is associated with arterial stiffening in healthy postmenopausal women.

Methods We conducted a cross-sectional study including estrogen-deficient postmenopausal women who had a hysterectomy with ovarian preservation (n = 24; mean ± SE age, 59 ± 1 y) or with BLO (n = 21; 58 ± 2 y) and had no hysterectomy/no BLO (n = 58; 58 ± 1 y). Arterial stiffness (arterial compliance and β stiffness index) was measured by ultrasonography of the carotid artery.

Results Carotid artery compliance was lower in women with hysterectomy alone and in women with hysterectomy with BLO compared with women with no hysterectomy (0.66 ± 0.03 and 0.71 ± 0.06 vs 0.89 ± 0.03 mm2/mm Hg × 10−1, respectively, both P < 0.05). There were no differences in traditional CVD risk factors (ie, adiposity, blood pressure and fasted lipids and lipoproteins, glucose, and insulin) between the groups. After adjustment for age, menopause duration, previous menopausal hormone therapy duration, parity, waist-to-hip ratio, systolic blood pressure, and sex hormone–binding globulin, hysterectomy status remained a significant predictor of arterial compliance.

Conclusions These results indicate that hysterectomy status (with or without BLO) is associated with greater arterial stiffening in estrogen-deficient postmenopausal women. The greater arterial stiffening with hysterectomy was not related to an adverse CVD risk profile. Large artery stiffening may be an important mechanism by which hysterectomy increases the risk of CVD in postmenopausal women.

From the 1Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, Aurora, CO; 2Human Performance Laboratory, Department of Kinesiology, College of Health and Human Performance, East Carolina University, Greenville, NC; 3Division of Cardiology, Department of Medicine, University of Colorado Denver, Aurora, CO; and 4Department of Integrative Physiology, University of Colorado at Boulder, Boulder, CO.

Received November 7, 2011; revised and accepted January 10, 2012.

Funding/support: This study was supported by National Institutes of Health awards AG027678, AG20683, AG122241, and AG18857; Colorado Clinical Translational Sciences Institute RR-025780; and University of Colorado Denver (UCD) Center for Women’s Health Research Junior Faculty Development Award and UCD Women’s Health Research Pilot Project Grant.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Kerrie L. Moreau, PhD, Division of Geriatric Medicine, University of Colorado Denver, Bldg L15 Rm 8111, 12631 East 17th Ave, PO Box 6511, Aurora, CO 80045. E-mail:

©2012The North American Menopause Society