A new study published today in the Journal of the American Heart Association reveals that women diagnosed with uterine fibroids face a significantly elevated long-term risk of heart disease. The research, which analyzed health data from more than 2.7 million U.S. women over a 10-year period, found that the risk of developing cardiovascular disease was 81% higher among those with fibroids compared to those without.
Uterine fibroids are benign growths that develop from the muscle tissue of the uterus. According to the U.S. Office of Women’s Health, up to 80% of women may develop fibroids by age 50. Despite their prevalence, fibroids remain understudied. “Nearly 26 million pre-menopausal women in the U.S. are impacted by uterine fibroids and many do not experience any symptoms. Yet despite the high prevalence, fibroids are understudied and poorly understood,” 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 in Philadelphia.
The study examined data from 2000 to 2022, comparing over 450,000 women with fibroids to nearly 2.25 million without. After adjusting for sociodemographic factors, cardiovascular risk factors, and reproductive history, the researchers found that women with fibroids had a persistently higher risk of developing coronary artery disease, cerebrovascular disease (including stroke), and peripheral artery disease. At 10 years, more than 5.4% of women with fibroids had experienced a cardiovascular event compared to 3% of women without fibroids.
The association was particularly strong in younger women. Among those under age 40, the risk for cardiovascular disease was 251% higher (more than 3.5 times more likely) in women with fibroids compared to those without. The increased risk persisted across all racial and ethnic groups, including white, Black, Hispanic, and Asian women.
“The strength of the relationship between heart disease risk and uterine fibroids was striking,” DiTosto said. “However, it's important to note that more research is needed to confirm these findings in other populations before formal changes are made to cardiovascular risk assessment guidelines. In the meantime, these results support having thoughtful conversations between women and their providers about heart health in the context of a fibroid diagnosis.”
Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association, emphasized the broader implications. “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,” she said. “It also is an opportunity to recognize the very important role all of a woman’s health care clinicians can play in her overall health, including heart health. 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 findings suggest that women diagnosed with fibroids may benefit from enhanced attention to heart health and risk factor management. However, the study had limitations, including the possibility that fibroids may not have been diagnosed in some women in the comparison group, which could have impacted the results. The researchers call for further studies to confirm the relationship and explore underlying biological pathways, which may include smooth muscle cell growth, fibrous connective tissue buildup, calcification, and inflammatory responses.
