Long-term cardiovascular disease risk increased in women diagnosed with uterine fibroids

A new retrospective analysis of more than 2.7 million women in the United States found that long-term cardiovascular disease risk was substantially higher among women diagnosed with uterine fibroids compared with women without fibroids, according to research published in the Journal of the American Heart Association.¹

Uterine fibroids are common benign growths of uterine muscle tissue, with the US Office of Women’s Health estimating that up to 80% of women will develop fibroids by age 50. However, investigators noted that despite their prevalence, the possible association between fibroids and cardiovascular disease has not been well defined.¹

“Nearly 26 million pre-menopausal women in the United States are impacted by uterine fibroids, and many do not experience any symptoms. Yet despite the high prevalence, fibroids are understudied and poorly understood,” study author Julia D. DiTosto, MS, said. “Some studies have shown that fibroids and cardiovascular disease share biological pathways, including the growth of smooth muscle cells, the excessive buildup of fibrous connective tissue, calcification, and inflammatory responses.”

How was the study on uterine fibroids and heart disease conducted?

The analysis used inpatient, outpatient, and pharmacy claims data from commercially insured women between 2000 and 2022 from Optum’s Clinformatics Data Mart. Researchers identified uterine fibroids by International Classification of Diseases (ICD), Current Procedural Terminology (CPT), or Healthcare Common Procedure Coding System (HCPCS) codes, requiring more than 1 claim at least 1 day apart or a single claim preceded by a transvaginal ultrasound or pelvic magnetic resonance imaging within 30 days.

Women with fibroids were matched to women without fibroids, generating a study population of 450,177 women with fibroids and 2,250,885 controls, with a mean age of 41 years. Over 10 years, investigators examined incident coronary artery disease, cerebrovascular disease, and peripheral artery disease.

What cardiovascular outcomes were associated with uterine fibroids?

After 10 years of follow-up, women with fibroids were at higher risk for each of the major cardiovascular outcomes assessed. Overall cardiovascular disease risk was 81% higher among participants with fibroids than among those without fibroids. More than 5.4% of women with fibroids experienced a cardiovascular event compared with approximately 3% of women without fibroids.

In subgroup analyses, increased cardiovascular risk persisted across racial and ethnic groups. Among women younger than 40 years, cardiovascular disease risk was more than 3.5-fold higher in those diagnosed with fibroids.

“We set out to address these critical gaps using a large, diverse dataset with extended follow-up,” DiTosto said. “Our findings suggest that fibroids may serve as an important marker for identifying women at elevated cardiovascular risk, with sustained increased risk persisting up to 10 years after diagnosis.”

According to the investigators, these results suggest that women with fibroids may benefit from increased attention to heart health, although additional studies are needed to confirm the findings. “However, it's important to note that more research is needed to confirm these findings in other populations before formal changes are made to cardiovascular risk assessment guidelines,” DiTosto said. “In the meantime, these results support having thoughtful conversations between women and their providers about heart health in the context of a fibroid diagnosis.”

What are the clinical implications for women with uterine fibroids?

Stacey E. Rosen, MD, FAHA, volunteer president of the American Heart Association, said the results underline the relevance of cardiovascular risk assessment in women’s health care settings. “This study highlights yet another aspect of the unique factors that impact women in regard to the leading cause of death among them — cardiovascular disease,” Rosen said. She noted that routine gynecologic care often serves as the main point of interaction with the health system for many women. “These findings linking fibroids to heart disease support the need to discuss the bigger picture that considers ways to identify and reduce cardiovascular disease risk, even among those women who may not have any other apparent risk factors.”

What are the limitations of this uterine fibroid study?

Because fibroids may be underdiagnosed, some women in the comparison cohort may have had undetected fibroids. The researchers attempted to adjust for this, but the limitation may have influenced the results.

References

1. American Heart Association. Uterine fibroids linked to elevated heart disease risk. American Heart Association. December 10, 2025. Accessed December 10, 2025. https://newsroom.heart.org/news/uterine-fibroids-linked-to-elevated-heart-disease-risk?preview=8fe7&preview_mode=True
2. Association Between Uterine Fibroids and Risk of Atherosclerotic Cardiovascular Disease, Journal of the American Heart Association (2025). DOI: 10.1161/JAHA.125.044014