Increased risk of coronary heart disease with hysterectomy in young women: A longitudinal follow-up study using a national health screening cohort.

OBJECTIVE

Hysterectomy is one of the most commonly performed gynecological procedures. Several studies have reported an association between hysterectomy and coronary heart disease (CHD), but the conclusions are controversial. This study aimed to evaluate the association between hysterectomy and the occurrence of CHD using a national sample cohort from South Korea.

STUDY DESIGN

Using the national cohort from the Korean National Health Insurance Service, we extracted data on patients who had undergone hysterectomy (n = 8,642) and on controls matched at a ratio of 1:4 (n = 34,568) and then analyzed the occurrence of CHD from 2002 to 2013. Patients were matched according to age, income, region of residence, obesity, smoking, alcohol consumption, and medical history.

MAIN OUTCOME MEASURES

A Cox proportional hazards model was used to analyze the hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses were performed based on both age and bilateral salpingo-oophorectomy (BSO) status. The age of the participants was defined as that at the time of hysterectomy.

RESULTS

The HR for CHD was 1.05 (95% CI = 0.96-1.16, p = 0.286) in the hysterectomy group. The HRs for CHD according to the different age subgroups were 1.19 (95% CI = 1.03-1.38, p = 0.018) for patients aged < 50 years, 1.05 (95% CI = 0.89-1.25, p = 0.561) for patients aged 50-59 years, and 0.88 (95% CI = 0.73-1.05, p = 0.147) for patients aged ≥ 60 years.

CONCLUSION

The incidence of CHD was statistically significantly higher in women who underwent hysterectomy when they were under 50 years of age than in the matched controls.