Study Reveals Significant Link Between Uterine Fibroids and Increased Heart Disease Risk in Women

A comprehensive 10-year study of more than 2.7 million U.S. women has revealed that those diagnosed with uterine fibroids face a substantially elevated risk of developing cardiovascular disease, with long-term heart disease risk more than 80% higher compared to women without fibroids. The research, published in the Journal of the American Heart Association, suggests fibroids may serve as an important marker for identifying women at increased cardiovascular risk, with implications lasting up to a decade after diagnosis.

Uterine fibroids are predominantly benign growths that develop from the muscle tissue of the uterus, affecting as many as 20% to 80% of women by age 50 according to the U.S. Office of Women’s Health. Despite their high prevalence, fibroids remain understudied, with nearly 26 million pre-menopausal women in the U.S. impacted, many without experiencing symptoms. "Some studies have shown that fibroids and cardiovascular disease share biological pathways, including the growth of smooth muscle cells, the excessive buildup of fibrous connective tissue, calcification and inflammatory responses," explained 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 analyzed health information from 2000 to 2022, comparing more than 450,000 females with fibroids to nearly 2.25 million without the condition, with an average age of 41 years. Over the following decade, they monitored for incidences of coronary artery disease (including heart attack), cerebrovascular disease (stroke and related conditions), and peripheral artery disease. The findings were striking: after 10 years of follow-up, women with fibroids were at higher risk for all three major cardiovascular conditions, with 81% higher overall cardiovascular disease risk compared to those without fibroids. Specifically, more than 5.4% of women with fibroids experienced a cardiovascular event compared to 3% of women without fibroids.

The elevated heart disease risk persisted across all racial and ethnic groups studied (white, Black, Hispanic and Asian), but was particularly pronounced among younger women. For those under age 40, the risk for cardiovascular disease was 251% higher (more than 3.5 times more likely) in women with fibroids compared to those without. "The strength of the relationship between heart disease risk and uterine fibroids was striking," DiTosto noted, while emphasizing that more research is needed to confirm these findings in other populations before formal changes are made to cardiovascular risk assessment guidelines.

These findings have significant implications for women's healthcare, particularly regarding how different medical specialties collaborate on patient care. "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," said Stacey E. Rosen, M.D., FAHA, volunteer president of the American Heart Association. "Because many women may use annual 'well-woman' visits to their gynecologist or their general practitioner as their primary point of care, these visits offer exceptional opportunities that go beyond gynecologic health."

The research suggests that fibroid diagnosis could serve as a trigger for enhanced cardiovascular risk assessment and preventive conversations. Rosen emphasized that these findings support the need to discuss the bigger picture that considers ways to identify and reduce cardiovascular disease risk, even among women who may not have other apparent risk factors. While the study has limitations, including potential underdiagnosis of fibroids in the comparison group, its large, diverse dataset with extended follow-up addresses previous research gaps and provides compelling evidence for a previously underrecognized connection between gynecologic and cardiovascular health.