RELATION BETWEEN BENIGN GYNECOLOGICAL DISEASES AND INCIDENT HYPERTENSION IN THE E3N COHORT

Objective: It has been reported that women with uterine fibroids are more often overweight and hypertensive but the prospective relationship between benign gynecological diseases and the subsequent risk of hypertension remains unknown The aim of our study was to investigate whether a past history of benign gynecological diseases (uterine fibroids, endometriosis, ovarian cysts) is related to an increased risk of incident hypertension a large French prospective cohort of women. Design and method: 50 286 women from the E3N cohort free of hypertension at baseline were followed up for a mean of 16.4 years. Women with cases of gynecological cancers were excluded from the analysis. Gynecological diseases were self-reported. Cox proportional hazard models with age as time-scale were used to estimate Hazard Ratios (HR) and 95% confidence intervals (CI). Covariates included smoking status, BMI, diet, physical activity and familial history of hypertension. Results: A total of 12 073 (24%) women developed hypertension during the follow-up. Women with a history of hysterectomy had an increased risk of incident hypertension, which persisted after adjustment for the main confounding factors (adjusted HR = 1.18, 95% CI 1.13–1.24). The association was not altered after further adjustment for reproductive factors or hormonal treatments. A history of fibroids was also significantly related to the risk of hypertension over the follow-up period (adjusted HR = 1.18; 95%CI: 1.13 – 1.23). Women with endometriosis (adjusted HR = 1.19, 95% CI 1.11–1.28) and those with a history of ovarian cysts (adjusted HR = 1.12, 95% CI 1.06–1.17) were at greater risk of developing hypertension. There was no interaction between the presence of overweight at baseline (BMI > 25 kg/m2) and the increased risk of incident hypertension related to the gynecological diseases. Conclusions: Women who had a history of benign gynecological diseases (fibroids, hysterectomy, fibroids, endometriosis, ovarian cysts) had an increased risk of developing incident hypertension. These findings suggest to take into account gynecological history of women who are at risk of hypertension