TABLE 3.
Cumulative incidence of cardiovascular and metabolic conditions in strata by hysterectomy indicationa
| Hysterectomy
|
Referent Women
|
Unadjusted Modelsc |
Adjusted Modelsd |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Condition | N at Risk |
Person -years |
N of Events |
Absolute Riskb % (95% CI) |
N at Risk |
Person -years |
N of Events |
Absolute Riskb % (95% CI) |
Hazard Ratio (95% CI) |
P | Hazard Ratio (95% CI) |
P | |
| Leiomyomas | |||||||||||||
| Hyperlipidemia | 761 | 10,596 | 433 | 77.4 (72.6-82.0) | 783 | 10,773 | 358 | 72.6 (67.0-77.9) | 1.25 (1.09-1.43) | 0.001 | 1.22 (1.06-1.40) | 0.004 | |
| Hypertension | 763 | 11,899 | 355 | 63.6 (58.6-68.6) | 760 | 11,532 | 284 | 60.8 (54.8-66.8) | 1.22 (1.05-1.42) | 0.01 | 1.15 (0.99-1.34) | 0.07 | |
| Diabetes | 801 | 14,367 | 248 | 51.2 (45.7-56.9) | 810 | 13,904 | 207 | 48.6 (42.9-54.5) | 1.17 (0.98-1.39) | 0.09 | 1.14 (0.95-1.36) | 0.16 | |
| Obesity | 710 | 12,150 | 183 | 34.7 (30.0-39.9) | 745 | 12,134 | 160 | 32.2 (27.7-37.3) | 1.14 (0.93-1.41) | 0.21 | 1.09 (0.89-1.35) | 0.41 | |
| Cardiac arrhythmias | 797 | 14,330 | 250 | 48.8 (43.7-54.3) | 809 | 14,168 | 196 | 41.8 (36.6-47.4) | 1.32 (1.10-1.58) | 0.003 | 1.28 (1.07-1.54) | 0.007 | |
| Coronary artery disease | 815 | 15,621 | 116 | 24.1 (19.8-29.2) | 818 | 15,051 | 101 | 21.4 (17.3-26.3) | 1.15 (0.89-1.50) | 0.28 | 1.11 (0.85-1.45) | 0.44 | |
| Congestive heart failure | 824 | 16,616 | 47 | 9.6 (6.9-13.4) | 823 | 15,562 | 50 | 10.3 (7.5-14.0) | 0.86 (0.58-1.26) | 0.44 | 0.82 (0.55-1.21) | 0.31 | |
| Stroke | 821 | 16,314 | 67 | 13.8 (10.5-18.0) | 824 | 15,496 | 61 | 12.7 (9.6-16.8) | 1.05 (0.75-1.48) | 0.77 | 1.03 (0.73-1.46) | 0.87 | |
| Menstrual disorders | |||||||||||||
| Hyperlipidemia | 518 | 8,435 | 282 | 69.9 (64.2-75.4) | 521 | 8,337 | 240 | 68.8 (62.8-74.6) | 1.23 (1.04-1.45) | 0.02 | 1.09 (0.91-1.30) | 0.35 | |
| Hypertension | 506 | 9,238 | 214 | 58.7 (52.6-65.0) | 513 | 9,077 | 170 | 51.3 (45.1-57.7) | 1.30 (1.07-1.59) | 0.009 | 1.21 (0.98-1.49) | 0.07 | |
| Diabetes | 525 | 10,538 | 163 | 49.4 (43.1-56.1) | 529 | 10,090 | 149 | 45.1 (38.9-51.7) | 1.09 (0.88-1.36) | 0.42 | 1.06 (0.85-1.33) | 0.61 | |
| Obesity | 470 | 8,736 | 144 | 38.5 (32.9-44.7) | 486 | 8,695 | 114 | 33.6 (28.4-39.5) | 1.26 (0.99-1.61) | 0.06 | 1.14 (0.89-1.47) | 0.31 | |
| Cardiac arrhythmias | 523 | 10,564 | 146 | 37.7 (32.1-44.0) | 526 | 10,373 | 104 | 31.7 (26.3-37.8) | 1.41 (1.10-1.81) | 0.006 | 1.25 (0.96-1.62) | 0.10 | |
| Coronary artery disease | 530 | 11,345 | 75 | 21.7 (17.0-27.3) | 533 | 11,008 | 39 | 12.5 (8.7-17.8) | 1.97 (1.34-2.89) | <0.001 | 1.81 (1.21-2.72) | 0.004 | |
| Congestive heart failure | 533 | 11,806 | 28 | 7.6 (4.9-11.7) | 532 | 11,229 | 18 | 6.4 (3.8-10.8) | 1.49 (0.83-2.67) | 0.19 | 1.14 (0.62-2.11) | 0.68 | |
| Stroke | 533 | 11,684 | 32 | 8.9 (5.9-13.3) | 534 | 11,149 | 29 | 9.5 (6.6-13.5) | 1.06 (0.65-1.74) | 0.82 | 0.86 (0.50-1.49) | 0.60 | |
| Uterine prolapse | |||||||||||||
| Hyperlipidemia | 408 | 6,290 | 218 | 71.1 (63.9-78.0) | 415 | 6,189 | 177 | 67.9 (60.3-75.3) | 1.22 (1.01-1.47) | 0.04 | 1.16 (0.96-1.41) | 0.12 | |
| Hypertension | 388 | 6,264 | 193 | 69.4 (61.1-77.3) | 395 | 6,194 | 158 | 60.5 (53.2-67.9) | 1.17 (0.95-1.43) | 0.13 | 1.10 (0.89-1.35) | 0.39 | |
| Diabetes | 414 | 8,014 | 142 | 54.1 (46.6-62.0) | 412 | 7,375 | 105 | 45.3 (37.8-53.5) | 1.23 (0.97-1.57) | 0.09 | 1.14 (0.89-1.46) | 0.30 | |
| Obesity | 368 | 6,436 | 110 | 39.6 (32.9-47.0) | 393 | 6,838 | 72 | 29.2 (22.8-37.0) | 1.65 (1.23-2.22) | <0.001 | 1.59 (1.17-2.14) | 0.003 | |
| Cardiac arrhythmias | 416 | 8,011 | 135 | 48.4 (41.1-56.3) | 413 | 7,516 | 122 | 47.7 (40.4-55.5) | 0.95 (0.75-1.20) | 0.67 | 0.87 (0.68-1.11) | 0.26 | |
| Coronary artery disease | 420 | 8,717 | 81 | 27.1 (21.5-33.8) | 421 | 8,079 | 56 | 19.2 (14.6-25.0) | 1.29 (0.91-1.82) | 0.15 | 1.27 (0.89-1.81) | 0.18 | |
| Congestive heart failure | 425 | 9,176 | 35 | 11.7 (8.0-17.0) | 421 | 8,302 | 47 | 16.6 (12.3-22.2) | 0.62 (0.40-0.97) | 0.03 | 0.59 (0.38-0.92) | 0.02 | |
| Stroke | 425 | 9,084 | 45 | 14.9 (10.8-20.4) | 421 | 8,202 | 45 | 18.3 (13.6-24.4) | 0.86 (0.57-1.31) | 0.49 | 0.77 (0.50-1.18) | 0.22 | |
A total of 308 women with other indications for hysterectomy were not included in the stratified analyses.
Absolute cumulative risk at 30 years after hysterectomy (or index) calculated using the Kaplan-Meier method. The estimates were adjusted using inverse probability weights derived from a logistic regression model including all 20 chronic conditions present at baseline, years of education (≤12, 13-16, >16, unknown), race (white vs nonwhite), and age and calendar year at baseline (continuous). These adjustments were performed separately in each stratum to maximize the balance at baseline.
Hazard ratios calculated using Cox proportional hazards models with age as the time scale.
Hazard ratios calculated using Cox proportional hazards models with age as the time scale and adjusted using inverse probability weights derived from a logistic regression model including all 20 chronic conditions present at baseline, years of education (≤12, 13-16, >16, unknown), race (white vs nonwhite), and age and calendar year at baseline (continuous). These adjustments were performed separately in each stratum to maximize the balance at baseline.