Association of Hysterectomy With Hypertension Incidence in Korean Women: A Nationwide Cohort Study

Abstract

Objective: To evaluate the association between hysterectomy and the development of hypertension in Korean women aged 40 to 59 years.

Patients and methods: In this Korean nationwide cohort study, 802,916 women aged 40 to 59 years were selected for analysis from January 1, 2002, to December 31, 2011. In total, 13,650 pairs were included in the hysterectomy and nonhysterectomy groups after 1:1 propensity score matching in several covariates. The participants were followed-up until December 31, 2020. The primary outcome was the development of hypertension during follow-up.

Results: During median follow-up periods (10.6 years [IQR, 9.2 to 12.6 years]; 10.9 years [IQR, 9.2 to 12.8 years]), the incidence of hypertension was 22 per 1000 person-years and 20 per 1000 person-years for the hysterectomy and nonhysterectomy groups, respectively. The hysterectomy group had a significantly higher rate of development of hypertension than that of the nonhysterectomy group (hazard ratio, 1.11; 95% CI, 1.05 to 1.17; P<.001). The risk was prominent in women whose hemoglobin level increased by 2 g/dL or more after hysterectomy. In women who had an adnexa-sparing hysterectomy, the incidence of hypertension was higher (hazard ratio, 1.15; 95% CI, 1.08 to 1.23; P<.001) than that in the nonhysterectomy group.

Conclusion: The findings of this cohort study suggest that women who undergo hysterectomy have a higher risk of hypertension than those with an intact uterus.