Halli Shiva S, Singh Dharmendra P, Biradar Rajeshwari A
Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
School of Research Methodology, Tata Institute of Social Sciences, Mumbai, India.
Am J Prev Cardiol. 2020 Nov 24;4:100131. doi: 10.1016/j.ajpc.2020.100131. eCollection 2020 Dec.
In recent years, hysterectomy has received increased attention in health policy debates in India. On the other hand, based non-communicable disease specific data for India, in 2011, WHO portray a grim picture and recommended to the government a 20% reduction in hypertension by 2020; however, the trends show that it is increasing. Yet, to date, there has not been a single nationally representative study of hypertension prevalence among women who undergo a hysterectomy.
The study has used the Indian fourth round of National Family Health Survey data, which is a cross-sectional nationally representative sample of 699,686 women in the age group 15-49 years and conducted during 2015-16. Bivariate and multivariate logistic regressions were used to examine the effect of hysterectomy on increased odds of hypertension among women of reproductive age groups.
The age adjusted prevalence of hypertension was higher among women those who undergone hysterectomy (11.9%) compared to non-hysterectomy women (10.6%). The pattern holds true among relevant background characteristics such as age, place of residence, education, caste, religion, wealth, family size, years since hysterectomy, body mass index (BMI), anaemia and consumption of tobacco. The adjusted odds of hypertension among women who underwent hysterectomy compared to those who did not was 1.72 (95% CI: 1.14-2.58).
The results indicated increased hypertension level among hysterectomy women. However, these results are based on a cross-sectional study, and hence, further through investigation based on a prospective study is necessary before undertaking any policy changes. Meanwhile, the government of India may like to suggest surveillance to the general practitioners as well as obstetricians and gynaecologists following a hysterectomy in order to better understand the effect of hysterectomy on hypertension.
近年来，子宫切除术在印度的卫生政策辩论中受到了越来越多的关注。另一方面，根据印度非传染性疾病的具体数据，2011年，世界卫生组织描绘了一幅严峻的图景，并建议政府到2020年将高血压发病率降低20%；然而，趋势表明其发病率正在上升。然而，迄今为止，尚未有一项针对接受子宫切除术的女性高血压患病率的全国代表性研究。
该研究使用了印度第四轮全国家庭健康调查数据，这是一个具有全国代表性的横断面样本，涵盖了699686名年龄在15至49岁之间的女性，调查于2015年至2016年期间进行。采用双变量和多变量逻辑回归分析来研究子宫切除术对育龄妇女高血压患病几率增加的影响。
与未接受子宫切除术的女性（10.6%）相比，接受子宫切除术的女性经年龄调整后的高血压患病率更高（11.9%）。在年龄、居住地点、教育程度、种姓、宗教、财富、家庭规模、子宫切除术后年限、体重指数（BMI）、贫血和烟草消费等相关背景特征方面，这种模式同样成立。与未接受子宫切除术的女性相比，接受子宫切除术的女性患高血压的调整后几率为1.72（95%置信区间：1.14 - 2.58）。
结果表明接受子宫切除术的女性高血压水平升高。然而，这些结果基于横断面研究，因此，在进行任何政策改变之前，有必要通过前瞻性研究进行进一步调查。同时，印度政府可能希望建议全科医生以及产科医生和妇科医生在子宫切除术后进行监测，以便更好地了解子宫切除术对高血压的影响。
