Association between hysterectomy status and hypertension: Results from NHANES 2007– 2018 and two-sample Mendelian randomization study

Background Previous observational studies have shown an association between hysterectomy status and the risk of developing hypertension, but the exact relationship between the two is unclear. The aim of our study was to conduct an observational analysis of this relationship and to determine the causality of that relationship through a Mendelian randomization (MR) study. Methods This study included 12,628 participants from the 2007–2018 National Health and Nutrition Examination Survey 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 and diastolic blood pressure. Results Adjusted-weighted logistic regression revealed a significant association between hysterectomy status and the risk of developing hypertension (OR = 1.26, 95% 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 systolic blood pressure (beta =9.642, 95% CI: 2.125-17.159) and increased diastolic blood pressure (beta =6.695, 95% CI: 2.173-11.217). Conclusions Our study revealed that hysterectomy increases the risk of hypertension. Moreover, hysterectomy at an early age is associated with an increased prevalence of hypertension. Therefore, there is an urgent need to manage and monitor blood pressure in post hysterectomy patients.