How high blood pressure can raise the risk

By Staff 8 Min Read

  • 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.

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.

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.

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.”

Share This Article
Leave a comment