Experts say uterine fibroids are common in women under the age of 50.
- Researchers
report that women on medication for high blood pressure have a lower risk
for developing uterine fibroids.
- Uterine
fibroids are common in women under the age of 50.
- Experts
say more research is needed to determine how blood pressure medications
might influence fibroids.
Medications that help
control high blood pressure may offer a new strategy for the prevention of
uterine fibroids.
Research published in the journal JAMA Network Open reports
that women in midlife with untreated or new onset hypertension have
an increased risk of fibroids while those who are on antihypertensive
treatments for blood pressure have a lower risk.
“Investigation into
mechanisms and health implications is warranted; 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.
Nearly 120 million adults in the United States have high
blood pressure, also called hypertension. About 44% of them are women. High blood pressure can create
health issues for the heart as well as the eyes, kidneys, and brain.
Uterine
fibroids and high blood pressure
A growing body of research also suggests an association between high
blood pressure and uterine fibroids, a
type of muscular tumor that grows in the walls of the uterus.
“Several prospective
studies have now shown that elevated blood pressure associates with the
presence of uterine fibroids. While this does not prove causation per se, and
residual confounding is always possible, this has been a robust association
across multiple patient cohorts spanning women of different age ranges. One of
the most interesting new findings in this study is that treatment with
antihypertensive medications lowered the risk of a self-reported diagnosis of
uterine fibroids,” said Dr Vivek
Bhalla, an associate professor of medicine specializing in hypertension at
Stanford University in California who was not involved in the study.
“Based on both clinical
and basic research findings, there has been a suggestion that causes of
elevated blood pressure (eg activation of the renin-angiotensin system) may
contribute to uterine smooth muscle cell injury and, therefore, the development
of fibroids,” Bhalla told Medical
News Today. “Elevated blood pressure
itself, either via atherosclerosis or
shear stress or both, may also contribute. On the other hand, the presence of
uterine fibroids may also raise blood pressure. Therefore, the relationship may
be bidirectional but prospective studies suggest that hypertension may at least
cause fibroids.”
Between 20%
and 80% of women develop uterine fibroids by the time they are 50.
They are most common in women in their 40s and early 50s.
Research suggests there are some similarities between fibroids
and hypertension. Both are common, both are associated with morbidity, both
involve changes to smooth muscle cells, and both are more common in people of
African descent.
Fibroids don’t always
cause symptoms, but if symptoms do occur they can be challenging and
include pain,
heavy menstrual bleeding, frequent urination, and pressure in the rectum.
High blood
pressure medications may lower fibroid risk
Research suggests that
hypertension is a consistently identified risk factor for fibroids.
“Fibroids are one aspect
of a list of different reasons as to why being aware of your blood pressure
status, as well as treating it, is going to be critically important. We’re
starting to understand that the blood pressure in different organ systems is as
important as your heart,” Dr. Nicole Weinberg, a cardiologist at Providence Saint
John’s Health Center in California who was not involved in the study,
told Medical News Today.
The new research
suggests that some blood pressure medications may have an impact in preventing
fibroids from developing.
“Antihypertensive
medications can lower blood pressure and possibly the risk of atherosclerosis
and/or smooth muscle injury of the arteries that
provide blood flow to the uterus. There are also classes of antihypertensive
medications, ie inhibitors of the renin-angiotensin system, that may have a
direct effect. In this study, these inhibitors were associated with the largest
risk reduction,” Bhalla said.
However, the new
research does not determine how exactly blood pressure medications might work
to prevent fibroids from occurring.
Some experts argue more
research is needed before these findings can have clinical relevance.
“The study does not
really describe or postulate how anti-hypertensive medications might prevent
the development of uterine fibroids. The mechanism of action of all of these
anti-hypertensives are different. They just note that there is a correlation or
association between being treated for hypertension and incidence of uterine fibroids,”
said Dr. G. Thomas Ruiz, the lead OB/GYN at MemorialCare Orange
Coast Medical Center in California who was not involved in the study.
“This is the type of
study that really needs to focus on the mechanism of action on how an
anti-hypertension could potentially prevent the development of fibroids and
then produce a dose which minimizes systemic side effects while
achieving the preventative goal. I’m not sure this is realistic,” he told Medical News Today.
Hypertension
needs to be well managed
Dr.
Parveen Garg, a cardiologist at Keck Medicine of USC in California who was
not involved in the study, says while more research is needed, this study is an
important reminder that hypertension should be taken seriously.
“We already know that
high blood pressure, if it’s untreated, leads to pretty disastrous consequences
all throughout the body. But this basically just reinforces that we need to
take high blood pressure seriously and we need to treat it when we recognize
it,” he told Medical News Today.
“In general, we know
that hypertension causes much more serious comorbidities. Heart failure, stroke, heart
disease, kidney failure. If left untreated, it leads to some really serious
comorbidities that can be life threatening,” Garg added.
Regardless of whether or
not medications for high blood pressure help prevent fibroids, experts say it
is essential the people with hypertension take steps to manage their condition.
“With any patient with
hypertension, especially for patients at high cardiovascular risk, vigilant
attention to diet and lifestyle changes and as needed for persistently
elevated blood pressure, antihypertensive medications, lower overall
cardiovascular risk,” Bhalla said. “Whether treatment with medication lowers
the risk of the development of fibroids will require additional studies. This
paper is an intriguing step in that direction.”
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