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TOPLINE:

New-onset hypertension was associated with a 45% greater risk of developing fibroids than among women with no history of hypertension, according to a new study.

METHODOLOGY:

• Researchers analyzed data from 2570 women aged 43-52 years (median age, 45 years) over the course of 13 clinical visits starting in 1996 and ending in 2013. 
• At baseline, women had no history of fibroids; during each visit, participants received a blood pressure screening and tests for blood-based biomarkers indicating cardiovascular risks. 
• Women reported any new fibroid diagnoses during follow-up visits and prescriptions for blood pressure medications, if any. 
• Researchers compared fibroid development among women without hypertension to those who were being treated and those who were underdiagnosed for the condition, as well as with patient histories of the condition.

TAKEAWAY:

• Women with untreated hypertension had a 19% greater risk for a new fibroid diagnosis compared with those without hypertension (hazard ratio [HR], 1.19; 95% CI, 0.91-1.57). 
• Those with treated hypertension had a 20% lower risk for a new fibroid diagnosis than women without hypertension (HR, 0.80; 95% CI, 0.56-1.15). 
• Hypertensive women taking medications for their condition had a 37% lower risk of developing fibroids compared with hypertensive women who could have been taking medication but were not (HR, 0.63; 95% CI, 0.38-1.05); ACE inhibitor prescriptions specifically carried a 48% lower risk for fibroid development. 
• Women with new-onset hypertension had a 45% greater risk of developing a fibroid compared with women who had never had hypertension (HR, 1.45; 95% CI, 0.96-2.20). 

IN PRACTICE: 

"If the associations are causal, antihypertensive medication use where indicated may present an opportunity to prevent clinically apparent fibroid development at this high-risk life stage," the study authors wrote.

SOURCE: 

The study was led by Susanna D. Mitro, PhD, research scientist at the Division of Research at Kaiser Permanente Northern California in Oakland, California and published in JAMA Network Open.

LIMITATIONS:

Since fibroid diagnoses were self-reported, asymptomatic fibroids could have been unaccounted for. The study findings are not applicable to all women because some develop fibroids before age 42 years, the age of eligibility for study inclusion. Black women in particular often develop fibroids before midlife. Since researchers excluded women with a prior fibroid diagnosis, fewer Black women were included in the study. The study findings may have also been impacted due to how slow fibroids grow: Some may have existed but been undetected before the onset of hypertension.

DISCLOSURES:

The study was funded by the National Institutes of Health (NIH), the National Center for Research Resources, and the National Center for Advancing Translational Sciences. Wise received grants from NIH and personal fees from The Gates Foundation and Abbvie, Inc. Various authors received grants and support outside the submitted work.