Untreated and Untreated Hypertension Associated with Increased Risk of Fibroid Development in Midlife Women

A recent prospective study presented at the American Society for Reproductive Medicine (ASRM) annual meeting has found that midlife women with untreated and new-onset hypertension face an increased risk of developing fibroids. Contrarily, women already receiving treatment for hypertension, especially those using an angiotensin-converting enzyme (ACE) inhibitor, have a lower risk of fibroid diagnosis. The study, led by Susanna Mitro, PhD, a research scientist at Kaiser Permanente Northern California in Oakland, sheds light on potential preventive measures for clinically apparent fibroid development in midlife.

Mitro’s research indicates that blood pressure control may offer an opportunity to prevent the development of clinically apparent fibroids in midlife, which is considered a high-risk period. It is worth noting that by the age of 50, 70% to 80% of individuals with a uterus will have at least one fibroid. As fibroid etiology is still not entirely understood, the connection between hypertension and fibroid development is an important clue in unraveling the mysteries of this common gynecologic condition.

Previous research has suggested a potential link between the renin-angiotensin system (RAS) and fibroid development. The hormones involved in this system contribute to increased blood pressure, providing a rationale for investigating its impact on fibroids. Mitro’s study revealed that the use of ACE inhibitors, which interfere with the RAS pathway, was associated with a lower risk of fibroid diagnosis. These findings open up new avenues for exploring fibroid etiology and potential treatment options.

Mitro’s research involved analyzing data from the Study of Women’s Health Across the Nation (SWAN) cohort, which included women aged 42 to 52 with a uterus, at least one ovary, and recent menstrual activity. Participants were followed for 13 semi-annual visits, during which their blood pressure was monitored, and they reported any fibroid diagnosis and use of antihypertensive medication. The analysis included 2,570 women, and discrete survival analysis was used to test the longitudinal association between hypertension and fibroid development.

The results showed that women with untreated hypertension had an 18% higher risk of fibroid diagnosis compared to those without hypertension. Women with new-onset hypertension faced an even greater risk, with a 45% increase in fibroid diagnosis. In contrast, women already receiving treatment for hypertension had a 37% lower risk, and if they were using ACE inhibitors, the risk decreased by 48%.

Dr. Steven L. Young, President of the Society for Reproductive Endocrinology and Infertility, emphasizes the significance of this research in helping healthcare professionals and their patients understand the broader impact of uterine fibroids. Fibroids are not solely a reproductive system issue, but a prevalent gynecologic morbidity that requires attention and intervention.

The findings from this study highlight the importance of blood pressure control in preventing fibroid development in midlife women. By addressing hypertension and potentially utilizing ACE inhibitors, healthcare providers may have a preventive tool at their disposal. This approach could potentially mitigate the significant burden of fibroids and improve quality of life for affected individuals.

The study led by Susanna Mitro reveals a significant association between untreated and new-onset hypertension and an increased risk of fibroid development in midlife women. Conversely, treated hypertension, especially when using ACE inhibitors, appears to offer protection against fibroid diagnosis. These findings suggest that blood pressure control plays a crucial role in preventing clinically apparent fibroids and sheds light on the complex etiology of this common gynecologic disorder. Moving forward, further research is necessary to understand the mechanisms underlying the renin-angiotensin system’s impact on fibroids and develop targeted interventions for women at risk.


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