Hysterectomy is associated with large artery stiffening in estrogen-deficient postmenopausal women.
OBJECTIVE
Hysterectomy, with or without oophorectomy, is associated with increased cardiovascular disease (CVD) risk due, in part, to an adverse CVD risk factor profile. Large artery stiffening, a biomarker of vascular aging, increases the risk for CVD. We determined whether hysterectomy with or without bilateral oophorectomy (BLO) is associated with arterial stiffening in healthy postmenopausal women.


METHODS
We conducted a cross-sectional study including estrogen-deficient postmenopausal women who had a hysterectomy with ovarian preservation (n = 24; mean ± SE age, 59 ± 1 y) or with BLO (n = 21; 58 ± 2 y) and had no hysterectomy/no BLO (n = 58; 58 ± 1 y). Arterial stiffness (arterial compliance and β stiffness index) was measured by ultrasonography of the carotid artery.


RESULTS
Carotid artery compliance was lower in women with hysterectomy alone and in women with hysterectomy with BLO compared with women with no hysterectomy (0.66 ± 0.03 and 0.71 ± 0.06 vs 0.89 ± 0.03 mm/mm Hg × 10, respectively, both P < 0.05). There were no differences in traditional CVD risk factors (ie, adiposity, blood pressure and fasted lipids and lipoproteins, glucose, and insulin) between the groups. After adjustment for age, menopause duration, previous menopausal hormone therapy duration, parity, waist-to-hip ratio, systolic blood pressure, and sex hormone-binding globulin, hysterectomy status remained a significant predictor of arterial compliance.


CONCLUSIONS
These results indicate that hysterectomy status (with or without BLO) is associated with greater arterial stiffening in estrogen-deficient postmenopausal women. The greater arterial stiffening with hysterectomy was not related to an adverse CVD risk profile. Large artery stiffening may be an important mechanism by which hysterectomy increases the risk of CVD in postmenopausal women.
Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA.
Kathleen M
KM
Gavin
Catherine
C
Jankowski
Wendy M
WM
Kohrt
Brian L
BL
Stauffer
Douglas R
DR
Seals
Kerrie L
KL
Moreau
D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D002318:Cardiovascular Diseases; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D004967:Estrogens / Q000172:deficiency*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008875:Middle Aged; D010052:Ovariectomy; D010101:Oxygen Consumption; D017698:Postmenopause; D012307:Risk Factors; D014463:Ultrasonography; D059289:Vascular Stiffness
D004967:Estrogens