Hysterectomy in young women associates with higher risk of stroke: A nationwide cohort study

Jong Shiuan Yeh, Hao Min Cheng, Pai Feng Hsu, Shih Hsien Sung, Wen Ling Liu, Hsin Ling Fang, Shao Yuan Chuang

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background and purpose Hysterectomy is a common procedure for treatment of numerous gynecologic diseases. However, reduction of endogenous sex hormone levels has been reported in hysterectomized women, and the association of hysterectomy with the cardiovascular risk remains controversial. We aimed to investigate the influence of hysterectomy on the risk of stroke and coronary heart disease, with adjustment for traditional risk factors. Methods A nationwide population-based study was conducted using the Taiwan National Health Insurance database from 1 million sampling cohort data set. A total of 7605 women who underwent hysterectomy without simultaneous oophorectomy from 1997 to 2009 were identified. The control group consisted of 30,420 women without hysterectomy, selected by matching the age, hypertension, diabetes, dyslipidemia, and the commencement date of follow-up. Results A total of 558 strokes and 599 coronary heart diseases (CHD) developed during a median 7.24 years follow-up. The difference was not significant between women with and without hysterectomy for stroke (2.34 vs. 2.08 per 1000 person-year, p = 0.26) and CHD (2.39 vs. 2.26, p = 0.53). However, of the women who underwent hysterectomy before 45 years, the hazard ratio of hysterectomy was 2.29 (95% CI, 1.52-3.44) for stroke and 1.14 (95% CI, 0.71-1.83) for CHD. Conclusions Categorized by the patients' age at operation, the associations between hysterectomy and the risk of stroke were different. The excess risk of stroke was observed in women who had hysterectomy before 45 years and remained significant even after accounting for baseline cardiovascular risk factors.

Original languageEnglish
Pages (from-to)2616-2621
Number of pages6
JournalInternational Journal of Cardiology
Volume168
Issue number3
DOIs
Publication statusPublished - Oct 3 2013

Fingerprint

Hysterectomy
Cohort Studies
Stroke
Coronary Disease
Female Genital Diseases
National Health Programs
Gonadal Steroid Hormones
Ovariectomy
Dyslipidemias
Taiwan
Databases
Hypertension
Control Groups

Keywords

  • Cardiovascular disease
  • Coronary heart disease
  • Hysterectomy
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Hysterectomy in young women associates with higher risk of stroke : A nationwide cohort study. / Yeh, Jong Shiuan; Cheng, Hao Min; Hsu, Pai Feng; Sung, Shih Hsien; Liu, Wen Ling; Fang, Hsin Ling; Chuang, Shao Yuan.

In: International Journal of Cardiology, Vol. 168, No. 3, 03.10.2013, p. 2616-2621.

Research output: Contribution to journalArticle

Yeh, Jong Shiuan ; Cheng, Hao Min ; Hsu, Pai Feng ; Sung, Shih Hsien ; Liu, Wen Ling ; Fang, Hsin Ling ; Chuang, Shao Yuan. / Hysterectomy in young women associates with higher risk of stroke : A nationwide cohort study. In: International Journal of Cardiology. 2013 ; Vol. 168, No. 3. pp. 2616-2621.
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abstract = "Background and purpose Hysterectomy is a common procedure for treatment of numerous gynecologic diseases. However, reduction of endogenous sex hormone levels has been reported in hysterectomized women, and the association of hysterectomy with the cardiovascular risk remains controversial. We aimed to investigate the influence of hysterectomy on the risk of stroke and coronary heart disease, with adjustment for traditional risk factors. Methods A nationwide population-based study was conducted using the Taiwan National Health Insurance database from 1 million sampling cohort data set. A total of 7605 women who underwent hysterectomy without simultaneous oophorectomy from 1997 to 2009 were identified. The control group consisted of 30,420 women without hysterectomy, selected by matching the age, hypertension, diabetes, dyslipidemia, and the commencement date of follow-up. Results A total of 558 strokes and 599 coronary heart diseases (CHD) developed during a median 7.24 years follow-up. The difference was not significant between women with and without hysterectomy for stroke (2.34 vs. 2.08 per 1000 person-year, p = 0.26) and CHD (2.39 vs. 2.26, p = 0.53). However, of the women who underwent hysterectomy before 45 years, the hazard ratio of hysterectomy was 2.29 (95{\%} CI, 1.52-3.44) for stroke and 1.14 (95{\%} CI, 0.71-1.83) for CHD. Conclusions Categorized by the patients' age at operation, the associations between hysterectomy and the risk of stroke were different. The excess risk of stroke was observed in women who had hysterectomy before 45 years and remained significant even after accounting for baseline cardiovascular risk factors.",
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N2 - Background and purpose Hysterectomy is a common procedure for treatment of numerous gynecologic diseases. However, reduction of endogenous sex hormone levels has been reported in hysterectomized women, and the association of hysterectomy with the cardiovascular risk remains controversial. We aimed to investigate the influence of hysterectomy on the risk of stroke and coronary heart disease, with adjustment for traditional risk factors. Methods A nationwide population-based study was conducted using the Taiwan National Health Insurance database from 1 million sampling cohort data set. A total of 7605 women who underwent hysterectomy without simultaneous oophorectomy from 1997 to 2009 were identified. The control group consisted of 30,420 women without hysterectomy, selected by matching the age, hypertension, diabetes, dyslipidemia, and the commencement date of follow-up. Results A total of 558 strokes and 599 coronary heart diseases (CHD) developed during a median 7.24 years follow-up. The difference was not significant between women with and without hysterectomy for stroke (2.34 vs. 2.08 per 1000 person-year, p = 0.26) and CHD (2.39 vs. 2.26, p = 0.53). However, of the women who underwent hysterectomy before 45 years, the hazard ratio of hysterectomy was 2.29 (95% CI, 1.52-3.44) for stroke and 1.14 (95% CI, 0.71-1.83) for CHD. Conclusions Categorized by the patients' age at operation, the associations between hysterectomy and the risk of stroke were different. The excess risk of stroke was observed in women who had hysterectomy before 45 years and remained significant even after accounting for baseline cardiovascular risk factors.

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