Subclinical Atherosclerosis in Relation to Hysterectomy Status in Black Women

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Abstract

Background and Purpose

This study was designed to investigate whether black women who underwent hysterectomy only (n=59) or hysterectomy plus bilateral oophorectomy (n=25) were at increased risk of subclinical carotid atherosclerosis compared with black women who underwent natural menopause (n=54). The effects of both surgery and menopausal status were evaluated.

Methods

Women aged 34 to 58 years were recruited from the Pittsburgh, Pa, area. Postmenopausal status was defined as a serum follicle-stimulating hormone level of >30 mIU/mL. Carotid duplex scans were performed to assess the degree of focal plaque.

Results

Among premenopausal women, focal plaque was present in 20% of nonhysterectomized versus 49% of hysterectomized-only women (P=.004). Among postmenopausal women, plaque was present in 69% of nonhysterectomized women, 86% of women with hysterectomy only, and 48% of women with oophorectomy and hysterectomy (P=.056). Among postmenopausal women, hormone replacement therapy was used by 23% of women who had undergone natural menopause, 0% of women with hysterectomy only, and 36% of women with oophorectomy and hysterectomy. The prevalence of plaque was 33% among hormone replacement therapy users versus 73% among nonusers (P=.014). In multivariate analysis, independent associations with the presence of at least 1 plaque were postmenopausal status and hysterectomy only.

Conclusions

These data suggest that black women who undergo hysterectomy without oophorectomy may be at higher risk of subclinical carotid atherosclerosis than black women who undergo natural menopause or hysterectomy plus oophorectomy. (Stroke. 1998;29:759-764.)

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