Young Age at Hysterectomy and Elevated Hypertension Risk: A Combined Observational and Mendelian Randomization Study

Abstract

Purpose: This study aimed to conduct an observational analysis of the association between hysterectomy status and the risk of developing hypertension, and to determine the causality of that relationship through a Mendelian randomization (MR) study. Materials and Methods: The study utilized two independent cohorts: 12628 female participants from National Health and Nutrition Examination Survey (NHANES) (2007–2018) for observational analysis and genetic data from the UK Biobank/IEU Open GWAS for two-sample MR. This study included 12628 participants from the 2007–2018 NHANES and used weighted logistic regression to analyze the association between hysterectomy status and the risk of developing hypertension, followed by a subgroup analysis and restricted cubic splines (RCS) to further explore the associations. A two-sample MR study was conducted to determine the causal relationships between hysterectomy status and the risk of developing hypertension and increased systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results: Adjusted, weighted logistic regression revealed a significant association between hysterectomy status and the risk of developing hypertension [odds ratio (OR)=1.26, 95% confidence interval (CI): 1.04–1.52]. Both subgroup and RCS analyses revealed that a younger age at hysterectomy was associated with a greater risk of hypertension. MR showed a causal association between genetically predicted hysterectomy status and the risk of developing hypertension (OR=1.205, 95% CI: 1.043–1.392), increased SBP (beta=9.642, 95% CI: 2.125–17.159) and increased DBP (beta=6.695, 95% CI: 2.173–11.217). Conclusion: Hysterectomy is associated with an increased risk of hypertension, particularly among women who undergo the procedure at a younger age.