Cardiovascular risk in women with uterine fibroids of different ethnic groups

In young women admissions for myocardial infarction are rising and mortality rates are still higher than in men. Just as worryingly, ethnic disparities still exist with a higher mortality due to heart disease in young African compared to Caucasian women. In this thesis, we investigated a new female-specific cardiovascular risk factor: uterine fibroids. We showed that women with uterine fibroids have a worse cardiovascular risk compared to controls, with more hypertension and a higher cardiovascular disease burden. The association between hypertension and fibroids was confirmed in multi-ethnic samples of the Netherlands, Suriname and the U.S. Moreover, although African women already have the highest prevalence of hypertension and hypertension-related cardiovascular morbidity and mortality, this is further increased in the presence of uterine fibroids.
We postulated in this thesis that the association between fibroids and hypertension is due to common growth factors and vaso-active peptides, stimulating vascular contractility and smooth muscle proliferation.
This thesis illustrates that clinicians should be aware of the increased hypertension and cardiovascular risk of women with fibroids, in particular in African women, and be assertive in screening for hypertension and target organ damage.