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Hysterectomy and Risk of Cardiovascular Disease: A Meta-analysis
  • Zixuan Wang,
  • Xutong Li,
  • Dongfeng Zhang
Zixuan Wang
Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Shandong Province, China
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Dongfeng Zhang
Qingdao university
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Abstract

Background: The association of hysterectomy with risk of cardiovascular disease(CVD) remains unclear. Objective: To evaluate the relationship between hysterectomy and the risk of CVD. Search Strategy: Five databases and reference lists of relevant studies were systematically searched up to January 2020. Selection Criteria: Observational studies evaluating the relationship between hysterectomy and risk of CVD or its subordinate diseases and non-hysterectomy controls were retained. Data Collection and Analysis: Pooled relative risks (RRs) and 95% CI were calculated by random effects model. Subgroup analyses and meta-regressions were performed to explore potential sources of heterogeneity. Small-study effects were estimated by Egger’s test and funnel plot. Main Results: Fourteen articles were included in our meta-analysis. The pooled RR (95% CI) of ischemic heart disease risk for hysterectomy versus non-hysterectomy was 1.20 (95% CI: 1.08-1.35). In association between ischemic heart disease and hysterectomy with ovarian preservation or hysterectomy with oophorectomy, significant positive associations were observed. A significant association was also found with having hysterectomy before 50y (1.19; 95% CI:1.01-1.41), but not with after 50y (1.16; 95% CI: 0.87-1.54). Hysterectomy might increase the risk of hypertension and unclassified CVD, but have no influence on other subordinate diseases of CVD. Conclusions: hysterectomy, whether preserving ovaries or not, might increase the risk of ischemic heart disease and hypertension, not of stroke. Hysterectomy might increase the risk of ischemic heart disease and stroke in women who had surgery below 50y. Keywords: hysterectomy, cardiovascular disease, hysterectomy with ovarian preservation, hysterectomy with oophorectomy, age at operation, meta-analysis.