Long-term heart disease risk in women diagnosed with uterine fibroids was more than 80% higher than in women without fibroids, according to new research published today in the Journal of the American Heart Association. The study, which analyzed data from over 2.7 million U.S. women over a 10-year period, found that the elevated risk persisted across all races and ages but was particularly strong among women younger than 40.
Fibroids are benign growths that develop from the muscle tissue of the uterus. According to the U.S. Office of Women’s Health, as many as 20% to 80% of women will develop fibroids by age 50. “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.
Researchers examined a U.S. database of health information from 2000 to 2022, comparing more than 450,000 women with fibroids to nearly 2.25 million women without fibroids. Over the next decade, they monitored for incidences of coronary artery disease, cerebrovascular disease, and peripheral artery disease. After 10 years, more than 5.4% of women with fibroids had experienced a cardiovascular event, compared to 3% of women without fibroids. The risk of developing cardiovascular disease was 81% higher among those with fibroids. Among women under 40, the risk was 251% higher—more than 3.5 times greater—compared to those without fibroids.
“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.”
The study adjusted for sociodemographic factors, cardiovascular risk factors, mental health conditions, reproductive history, and healthcare utilization. Despite these adjustments, the link remained significant. Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association, noted that “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 emphasized that annual well-woman visits provide opportunities to discuss heart health, even among women without apparent risk factors.
The researchers acknowledged limitations, including the possibility that fibroids may not have been diagnosed in some women in the comparison group, which could impact results. They called for further studies to confirm the relationship and to explore potential biological pathways, such as smooth muscle cell growth and inflammatory responses, that may link fibroids and cardiovascular disease.
