Uterine Fibroids Linked to Over 80% Higher Long-Term Heart Disease Risk in Women

Women diagnosed with uterine fibroids face more than 80% higher long-term heart disease risk compared to women without fibroids, according to a 10-year study of over 2.7 million U.S. women 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.

Researchers from the University of Pennsylvania analyzed health data from 2000 to 2022, comparing 450,177 women with fibroids to 2,250,885 controls without fibroids. Over the following decade, they monitored for incidents of coronary artery disease, cerebrovascular disease, and peripheral artery disease. After 10 years of follow-up, 5.4% of women with fibroids had experienced a cardiovascular event compared to just 3% of women without fibroids.

"Nearly 26 million pre-menopausal women in the U.S. are impacted by uterine fibroids and many do not experience any symptoms," said study author Julia D. DiTosto, a Ph.D. candidate in epidemiology at the Perelman School of Medicine. "Our findings suggest 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."

The U.S. Office of Women's Health notes that as many as 20% to 80% of women will develop fibroids by age 50, making this potential connection to heart health particularly significant given cardiovascular disease remains the leading cause of death among women. DiTosto explained that previous research has shown fibroids and cardiovascular disease share biological pathways, including smooth muscle cell growth, excessive fibrous connective tissue buildup, calcification, and inflammatory responses.

"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."

Stacey E. Rosen, M.D., volunteer president of the American Heart Association, emphasized the importance of these findings for women's healthcare. "This study highlights yet another aspect in the unique factors that impact women in regard to the leading cause of death among them," she 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 adjusted for numerous factors including sociodemographic characteristics, cardiovascular risk factors, mental health conditions, reproductive history, cancer, healthcare utilization, and medication use. Researchers identified uterine fibroids using ICD-9/10, CPT, or HCPCS codes, requiring either multiple claims or a single claim preceded by specific imaging within 30 days.

While the study represents one of the largest investigations into this relationship, researchers acknowledge limitations including possible underdiagnosis of fibroids in the comparison group. The findings nonetheless suggest women diagnosed with fibroids may benefit from enhanced attention to heart health and risk factor management during their healthcare visits.