{"paper_id":"b0c9e25d-0bf0-4bd1-97f3-43b107eb5a58","body_text":"Author(s): N. Jayasree*1, K. Ruchitha2, Vijayalakshmi Cholavaram3, O. Susmitha4, Sk. Davood5\nEmail(s): 1nandipallijayasree3814@gmail.com\nAddress:\nDepartment of Pharmacy Practice, Swathi College of Pharmacy, Nellore, Andhra Pradesh\nPublished In: Volume - 4, Issue - 10, Year - 2025\nDOI: https://doi.org/10.71431/IJRPAS.2025.41006\nABSTRACT:\nHysterectomy, the surgical removal of the uterus, is one of the most frequently performed gynecological procedures worldwide. Beyond its reproductive and symptomatic benefits, growing evidence suggests that hysterectomy may have long-term systemic effects, particularly on cardiovascular health. Hypertension, a leading global risk factor for cardiovascular morbidity and mortality, has been increasingly reported among women with a history of hysterectomy. The mechanisms underlying this association are not fully established but may involve both hormonal and vascular pathways. In women who undergo hysterectomy with bilateral oophorectomy, abrupt estrogen deprivation accelerates vascular aging, endothelial dysfunction, and blood pressure dysregulation. Even when ovaries are preserved, reduced ovarian blood flow and earlier onset of ovarian insufficiency may predispose to hypertension. Several observational and cohort studies indicate that women, especially those operated at a younger age, are at higher risk of incident hypertension compared to age-matched controls. Additional factors such as obesity, diabetes mellitus, metabolic syndrome, and pre-existing gynaecological conditions like uterine fibroids or endometriosis may further increase susceptibility. While the absolute risk is modest, the high prevalence of hysterectomy amplifies the public health significance of this association. Early recognition and targeted preventive strategies, including cardiovascular monitoring, weight management, and lifestyle counselling, are essential for women after hysterectomy. Further prospective studies are warranted to clarify causal pathways and to guide individualized risk reduction strategies. Overall, hysterectomy appears to be a potential contributor to increased hypertension risk, underscoring the need for long-term vigilance in clinical practice.\nCite this article:\nN. Jayasree; K. Ruchitha; Vijayalakshmi Cholavaram; O. Susmitha; Sk. DavoodHysterectomy and Cardiometabolic Risk: A Comprehensive Review. IJRPAS, October 2025; 4(10): 85-95.DOI: https://doi.org/https://doi.org/10.71431/IJRPAS.2025.41006\n1.\nMikhail E., Salemi J., Mogos M., Hart S.,\nSalihu H., Imudia A. National trends of adnexal surgery at the time of\nhysterectomy for benign indication, United States 1998-2011. J. Minim. Invasive\nGynecol. 2015 Mar 1;22(3):S18. doi: 10.1016/j.ajog.2015.04.031\n2.\nMatthews KA, Gibson CJ, El Khoudary SR, et\nal. Changes in cardiovascular risk factors by hysterectomy status with and\nwithout oophorectomy: study of women’s health across the nation. J Am Coll\nCardiol 2013;62:191–200. doi:10.1016/j.jacc.2013.04.042FREE Full Text Google\nScholar\n3.\nJames SL, Abate D, Abate KH. Global,\nregional, and national incidence, prevalence, and years lived with disability\nfor 354 diseases and injuries for 195 countries and territories, 1990-2017: a\nsystematic analysis for the global burden of disease study 2017. Lancet\n2018;392:1789–858. doi:10.1016/S0140-6736(18)32279-7CrossRefPubMedGoogle\nScholar\n4.\nMosca, L. ∙ Benjamin, E.J. ∙ Berra, K. ...\nEffectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in\nWomen—2011 Update Circulation. 2011; 123:1243-1262 Crossref Scopus (1378)\nPubMed Google Scholar\n5.\nR. Venturella et al.3 to 5 Years later:\nlong-term effects of prophylactic bilateral salpingectomy on ovarian function\nB.G. Kim et al. Relation of preprocedural haemoglobin level to outcomes after\npercutaneous coronary intervention\n6.\nAarts JWM, Nieboer TE, Johnson N, et al.\nSurgical approach to hysterectomy for benign gynaecological disease. Cochrane\nDatabase Syst Rev 2015;2015:CD003677. doi: 10.1002/14651858.CD003677.pub5Google\nScholar\n7.\nInternational Institute for Population\nSciences (IIPS) and ICF. (2021). National Family Health Survey (NFHS-5),\n2019–21: India. Mumbai, India. Available at:\n8.\nBhaumik, S. (2013). Oxfam calls for new\nregulations to reduce unnecessary hysterectomies in private hospitals. BMJ,\n346, f852.\n9.\nMills, K. T., Stefanescu, A., & He, J.\n(2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16,\n223–237.\n10.\nZhou, B., Carrillo-Larco, R. M., Danaei,\nG., et al. (2021). Worldwide trends in hypertension prevalence and progress in\ntreatment and control from 1990 to 2019: A pooled analysis of 1201\npopulation-representative studies with 104 million participants. The Lancet,\n398, 957–980.\n11.\nJames, S. L., Abate, D., Abate, K. H., et\nal. (2018). Global, regional, and national incidence, prevalence, and years\nlived with disability for 354 diseases and injuries for 195 countries and\nterritories, 1990–2017: A systematic analysis for the Global Burden of Disease\nStudy 2017. The Lancet, 392, 1789–1858.\n12.\nDing, D.-C., & Sung, F.-C. (2018).\nAuthors’ reply re: Risk of hypertension after hysterectomy: A population-based\nstudy. BJOG, 125, 1780.\n13.\nLaughlin-Tommaso, S. K., Khan, Z., Weaver,\nA. L., et al. (2018). Cardiovascular and metabolic morbidity after hysterectomy\nwith ovarian conservation: A cohort study. Menopause, 25, 483–492.\n14.\nHalli, S. S., Singh, D. P., & Biradar,\nR. A. (2020). Increased hypertension following hysterectomy among reproductive\nwomen in India. American Journal of Preventive Cardiology, 4, 100131.\n15.\nMadika, A.-L., MacDonald, C. J., Gelot,\nA., et al. (2021). Hysterectomy, non-malignant gynaecological diseases, and the\nrisk of incident hypertension: The E3N prospective cohort. Maturitas, 150,\n22–29. https://doi.org/10.1016/j.maturitas.2021.06.001\n16.\nInternational Institute for Population\nSciences (IIPS). (2020). Longitudinal Ageing Study in India (LASI), Wave 1,\n2017–18: India Report. Mumbai, India. Available at:\n17.\nPerianayagam, A., Bloom, D., Lee, J., et\nal. (2022). Cohort profile: The longitudinal ageing study in India (LASI).\nInternational Journal of Epidemiology, 51, e167–e176.\n18.\nHammer, G. P., du Prel, J.-B., &\nBlettner, M. (2009). Avoiding bias in observational studies: Part 8 in a series\nof articles on evaluation of scientific publications. Deutsches Ärzteblatt\nInternational, 106, 664–668.\n19.\nHainmueller, J. (2012). Entropy balancing\nfor causal effects: A multivariate reweighting method to produce balanced\nsamples in observational studies. Political Analysis, 20, 25–46.\n20.\nHainmueller, J., & Xu, Y. (2013).\nEbalance: A Stata package for entropy balancing. Journal of Statistical\nSoftware, 54, 1–18.\n21.\nLuoto, R., Kaprio, J., Reunanen, A., et\nal. (1995). Cardiovascular morbidity in relation to ovarian function after\nhysterectomy. Obstetrics & Gynecology, 85, 515–522.\n22.\nLaughlin-Tommaso, S. K., Khan, Z., Weaver,\nA. L., et al. (2016). Cardiovascular risk sfactors and diseases in women\nundergoing hysterectomy with ovarian conservation. Menopause, 23, 121–128.\n23.\nMikhail, E., Miladinovic, B., Velanovich,\nV., et al. (2015). Association between obesity and the trends of routes of\nhysterectomy performed for benign indications. Obstetrics & Gynaecology,\n125, 912–918.\n24.\nHossain, F. B., Adhikary, G., Chowdhury,\nA. B., et al. (2019). Association between body mass index (BMI) and\nhypertension in South Asian population: Evidence from nationally-representative\nsurveys. Clinical Hypertension, 25, 28.\n25.\nDubey, R. K., Oparil, S., Imthurn, B., et\nal. (2002). Sex hormones and hypertension. Cardiovascular Research, 53,\n688–708.\n26.\nLizcano, F., & Guzmán, G. (2014).\nEstrogen deficiency and the origin of obesity during menopause. BioMed Research\nInternational, 2014, 757461.\n27.\nMaas, A. H. E. M., & Franke, H. R.\n(2009). Women’s health in menopause with a focus on hypertension. Netherlands\nHeart Journal, 17, 68–72.\n28.\nReckelhoff, J. F., & Fortepiani, L. A.\n(2004). Novel mechanisms responsible for postmenopausal hypertension.\nHypertension, 43, 918–923.","source_license":"CC0","license_restricted":false}