ORIGINAL CONTRIBUTIONS |
A Prospective Study of Hypertension and Risk of Uterine Leiomyomata
1 Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
2 Department of Maternal and Child Health, Harvard School of Public Health, Boston, MA
3 Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA
4 Department of Epidemiology, Harvard School of Public Health, Boston, MA
5 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
6 Department of Obstetrics, Gynecology, and Reproductive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
Correspondence to Dr. Rosalind Wright, The Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115 (rboynto3{at}jhmi.edu).
Although uterine leiomyomata (also known as fibroids or myomas) affect the reproductive health and well-being of approximately 25% of premenopausal women, risk factors are poorly understood. Elevated diastolic blood pressure may increase fibroid risk through uterine smooth muscle injury, not unlike atherosclerosis. The authors prospectively examined the relation between diastolic blood pressure and incidence of clinically detected leiomyomata. The sample included 104,233 premenopausal nurses from 14 US states enrolled in the Nurses' Health Study II. Participants, aged 25–42 years, had intact uteri and no history of cancer or fibroids at enrollment in 1989. During the 827,348 woman-years of follow-up (1989–1999), 7,466 incident diagnoses of uterine leiomyomata, confirmed by ultrasound or hysterectomy, were reported. With a multivariable Cox proportional hazards model, the relative risk of self-reported ultrasound- or hysterectomy-confirmed uterine leiomyomata according to diastolic blood pressure in 1989 and time-varying antihypertensive use was estimated. With adjustment for age, race/ethnicity, body mass index, and reproductive history covariates, for every 10-mmHg increase in diastolic blood pressure, the risk of fibroids rose 8% (5–11%) and 10% (7–13%) among nonusers and users of antihypertensive medications, respectively. Elevated blood pressure has an independent, positive association with risk for clinically detected uterine leiomyomata among premenopausal women. Investigating this association may suggest possible pathways to prevent fibroids.
blood pressure; cohort studies; hypertension; leiomyoma; uterine diseases; uterine neoplasms
Abbreviations: CI, confidence interval
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