Heart disease is the leading cause of death among women in the United States.1 Although cardiovascular and reproductive health may seem unrelated, could having uterine fibroids put a woman at an even higher risk of heart attack or stroke? According to a recent study published in the European Journal of Obstetrics & Gynecology and Reproductive Biology2, Aksoy and a team of researchers found that these conditions may be more connected than we think.
The Turkish study conducted at the Cardiology and Gynecology & Obstetrics Clinics in Trakya University looked at 292 women diagnosed with fibroids and 185 women without. In both groups, blood samples were taken and a carotid intima-media thickness test was used to detect any early signs of atherosclerosis. Using sound waves, this non-invasive procedure provides physicians with a visual of the carotid artery—the large blood vessel that runs along both sides of the neck. This makes it possible to spot vascular disease.3
Results showed that women with fibroids had notably thicker arteries in comparison to those without. What’s more, women with fibroids were also seen to have lower HDL (the “good” cholesterol) levels. And according to the American Heart Association, both of these outcomes are associated with an increased risk of heart disease.4,5
Healthy blood vessels are flexible and are able to expand and contract with blood flow and pressure. But when arteries become clogged with plaque made from different circulating fats and calcium deposits, they can become narrow and stiff—as seen with atherosclerosis. This makes it difficult for oxygen-rich blood to reach our organs and can dangerously lead to heart attack and stroke.
But why are women with fibroids at a higher risk if the problem lies within the arteries? According to the authors, several possibilities exist.
Although not entirely understood, the authors first highlighted that women with fibroids are also at an increased risk for high blood pressure. When blood pressure is abnormally high, they explained, the cells that line artery walls can be injured2 and release inflammatory proteins6 that may increase plaque deposits. The Nurses’ Health Study II showed that with each 10 mmHg increase of diastolic blood pressure (the bottom number indicating pressure when the heart is at rest between beats), a women’s risk of uterine fibroids rises 8 percent.6
In this way, injury to uterine blood vessels may play a role in the development of fibroids. “Observed abnormalities in the structure and function of the uterine vasculature in the presence of uterine [fibroids] invite the possibility that direct injury (caused by atherosclerosis) to uterine blood vessels may play a role,” the authors explained.
The authors further pointed out that many similarities2 exist between plaque formation and uterine fibroid growth. Both conditions are thought to come from a single abnormal smooth muscle cell. And in order for either disease to thrive, the cell needs to multiply rapidly. When the body detects this abnormal growth—whether it is along blood vessel walls or in the uterus—it tries to contain the injury by laying down fibrous and calcified tissue. This process is ongoing and, depending on the location, may lead to thickened arteries or uterine fibroids.
In addition to vascular thickening and high blood pressure, other factors like obesity are linked to uterine fibroids. A study examining fibroids in Chinese women6 reported such results. “These factors are also common cardiovascular risks and might be related to atherosclerosis,” collaborative authors stressed. “These shared patterns support the hypothesis that the development of uterine fibroids and the development of plaques (from atherosclerosis) share a common biological mechanism.”
Finally, the HDL connection. HDL cholesterol is thought to protect against vascular disease, heart attack, and stroke because it carries other cholesterols that could potentially promote atherosclerosis from the arteries to be processed in the liver. Lower HDL levels may put an individual at an increased risk of heart disease5 and may be the reason in these studies for a heighted risk of atherosclerosis in women with fibroids.6
“These findings suggest that women with uterine [fibroids] may have an increased risk of subclinical atherosclerosis,” Aksoy concluded. “Cardiovascular diseases are among the most prevalent causes of…mortality in developed communities” but “classical cardiovascular risks have not been observed in nearly one-half of these diseases.” For this reason, it’s crucial that new risk factors—like uterine fibroids—be investigated early on to detect hidden signs of heart disease so women can be treated accordingly.
ABOUT THE AUTHOR Alicia Armeli is a Health Freelance Writer, Registered Dietitian Nutritionist, and Certified Holistic Life Coach. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad and volunteering with her local animal shelter.
- United States Centers for Disease Control and Prevention. (2011). Leading Cause of Death by Race/Ethnicity, All Females-United States, 2011. Retrieved August 25, 2015, from http://www.cdc.gov/women/lcod/2011/WomenlRace_2011.pdf
- Aksoy, Y., Sivri, N., Karaoz, B., Sayin, C., & Yetkin, E. (2014). Carotid intima-media thickness: a new marker of patients with uterine leiomyoma. European Journal of Obstetrics & Gynecology and Reproductive Biology, 175: 54-57. doi:10.1016/j.ejogrb.2014.01.005
- Cedars-Sinai. (2015). Carotid Intima-Media Thickness Test. Retrieved August 26, 2015, from http://www.cedars-sinai.edu/Patients/Programs-and-Services/Womens-Heart-Center/Services/Carotid-Intima-Media-Thickness-Test.aspx
- American Heart Association. (2014). Atherosclerosis. Retrieved August 27, 2015, from http://www.heart.org/HEARTORG/Conditions/Cholesterol/WhyCholesterolMatters/Atherosclerosis_UCM_305564_Article.jsp
- American Heart Association. (2014). Good vs. Bad Cholesterol. Retrieved August 27, 2015, from http://www.heart.org/HEARTORG/Conditions/Cholesterol/AboutCholesterol/Good-vs-Bad-Cholesterol_UCM_305561_Article.jsp
- He, Y., Zeng, Q., Li, X., Liu, B., & Wang, P. (2013). The association between subclinical atherosclerosis and uterine fibroids. PLoS One, 8(2): e57089. doi: 10.1371/journal.pone.0057089