Table 3.
Case-control analyses on the association of preexisting cardiovascular risk factors and cardiovascular disease with hysterectomy with ovarian conservation stratified by indication for the surgery
| Risk Factor or Disease | Women with Hysterectomy n (%) | Referent Women n (%) | Univariable Analyses |
Multivariable Analysesa |
||||
|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | p-value | OR | 95% CI | p-value | |||
| Leiomyomas (1,125 cases; 1,125 controls) | ||||||||
| Cardiovascular risk factor | ||||||||
| Diabetes | 25 (2.2) | 31 (2.8) | 0.81 | (0.48-1.37) | 0.42 | 0.66 | (0.38-1.14) | 0.14 |
| Hyperlipidemia | 44 (3.9) | 40 (3.6) | 1.11 | (0.71-1.74) | 0.65 | 1.06 | (0.66-1.70) | 0.80 |
| Hypertension | 97 (8.6) | 92 (8.2) | 1.07 | (0.78-1.47) | 0.68 | 0.94 | (0.67-1.31) | 0.70 |
| Obesity | 201 (17.9) | 143 (12.7) | 1.52 | (1.20-1.93) | <0.001 | 1.59 | (1.23-2.04) | <0.001 |
| Metabolic syndromeb | 25 (2.2) | 15 (1.3) | 1.77 | (0.90-3.49) | 0.10 | ... | ... | ... |
| Polycystic ovary syndrome | 3 (0.3) | 3 (0.3) | 1.00 | (0.20-4.95) | 1.00 | 0.99 | (0.20-4.97) | 0.99 |
| Cardiovascular disease | ||||||||
| CAD | 10 (0.9) | 15 (1.3) | 0.64 | (0.28-1.49) | 0.30 | ... | ... | ... |
| CHF | 1 (0.1) | 7 (0.6) | 0.14 | (0.02-1.16) | 0.07 | ... | ... | ... |
| Myocardial infarction | 5 (0.4) | 5 (0.4) | 1.00 | (0.29-3.45) | 1.00 | ... | ... | ... |
| Cardiac disease compositec | 14 (1.2) | 19 (1.7) | 0.71 | (0.34-1.48) | 0.36 | ... | ... | ... |
| Stroke | 7 (0.6) | 6 (0.5) | 1.17 | (0.39-3.47) | 0.78 | ... | ... | ... |
| CVD composited | 21 (1.9) | 24 (2.1) | 0.86 | (0.47-1.60) | 0.64 | ... | ... | ... |
| Prolapse (805 cases; 805 controls) | ||||||||
| Cardiovascular risk factor | ||||||||
| Diabetes | 22 (2.7) | 33 (4.1) | 0.66 | (0.38-1.14) | 0.13 | 0.57 | (0.33-1.00) | 0.05 |
| Hyperlipidemia | 26 (3.2) | 13 (1.6) | 2.08 | (1.05-4.15) | 0.04 | 2.03 | (1.01-4.11) | 0.05 |
| Hypertension | 96 (11.9) | 86 (10.7) | 1.16 | (0.83-1.62) | 0.39 | 1.02 | (0.72-1.45) | 0.90 |
| Obesity | 146 (18.1) | 105 (13.0) | 1.49 | (1.13-1.97) | 0.005 | 1.49 | (1.12-1.99) | 0.007 |
| Metabolic syndromeb | 7 (0.9) | 7 (0.9) | 1.00 | (0.35-2.85) | 1.00 | ... | ... | ... |
| Polycystic ovary syndrome | 1 (0.1) | 0 (0.0) | ... | ... | ... | ... | ... | ... |
| Cardiovascular disease | ||||||||
| CAD | 19 (2.4) | 19 (2.4) | 1.00 | (0.53-1.89) | 1.00 | ... | ... | ... |
| CHF | 3 (0.4) | 6 (0.7) | 0.50 | (0.13-2.00) | 0.33 | ... | ... | ... |
| Myocardial infarction | 2 (0.2) | 5 (0.6) | 0.40 | (0.08-2.06) | 0.27 | ... | ... | ... |
| Cardiac disease compositec | 21 (2.6) | 22 (2.7) | 0.95 | (0.52-1.74) | 0.88 | ... | ... | ... |
| Stroke | 9 (1.1) | 13 (1.6) | 0.69 | (0.30-1.62) | 0.40 | ... | ... | ... |
| CVD composited | 27 (3.4) | 28 (3.5) | 0.96 | (0.57-1.64) | 0.89 | ... | ... | ... |
| Other indications (1,886 cases; 1,886 controls) | ||||||||
| Cardiovascular risk factor | ||||||||
| Diabetes | 42 (2.2) | 29 (1.5) | 1.46 | (0.91-2.37) | 0.12 | 1.32 | (0.80-2.15) | 0.27 |
| Hyperlipidemia | 65 (3.4) | 45 (2.4) | 1.47 | (0.99-2.16) | 0.05 | 1.28 | (0.86-1.91) | 0.22 |
| Hypertension | 114 (6.0) | 89 (4.7) | 1.35 | (0.99-1.84) | 0.05 | 1.19 | (0.86-1.63) | 0.29 |
| Obesity | 290 (15.4) | 221 (11.7) | 1.37 | (1.13-1.66) | 0.001 | 1.30 | (1.07-1.58) | 0.01 |
| Metabolic syndromeb | 27 (1.4) | 10 (0.5) | 2.89 | (1.35-6.16) | 0.006 | ... | ... | ... |
| Polycystic ovary syndrome | 6 (0.3) | 3 (0.2) | 2.00 | (0.50-8.00) | 0.33 | 1.69 | (0.42-6.83) | 0.46 |
| Cardiovascular disease | ||||||||
| CAD | 18 (1.0) | 10 (0.5) | 2.00 | (0.86-4.67) | 0.11 | ... | ... | ... |
| CHF | 3 (0.2) | 3 (0.2) | 1.00 | (0.20-4.95) | 1.00 | ... | ... | ... |
| Myocardial infarction | 5 (0.3) | 4 (0.2) | 1.25 | (0.34-4.65) | 0.74 | ... | ... | ... |
| Cardiac disease compositec | 20 (1.1) | 15 (0.8) | 1.42 | (0.68-2.97) | 0.36 | ... | ... | ... |
| Stroke | 11 (0.6) | 9 (0.5) | 1.22 | (0.51-2.95) | 0.66 | ... | ... | ... |
| CVD composited | 28 (1.5) | 23 (1.2) | 1.28 | (0.69-2.37) | 0.44 | ... | ... | ... |
OR, odds ratio; CI, confidence interval; CAD, coronary artery disease; CHF, congestive heart failure; CVD, cardiovascular disease.
The cardiovascular risk factors were evaluated in a full multivariable logistic regression model that included diabetes, hyperlipidemia, hypertension, obesity, and polycystic ovary syndrome. Metabolic syndrome was not included because it was defined using variables already included in the model.
Metabolic syndrome was defined as 3 or more of the following 4 conditions: hyperlipidemia, hypertension, diabetes, or obesity, or as a diagnosis of metabolic syndrome.
The cardiac disease composite included CAD, myocardial infarction, and CHF.
The CVD composite included CAD, myocardial infarction, CHF, and stroke.