Polymorphisms of Renin Angiotensin System Genes in Uterine Leiomyomas Among Egyptian Females

Gomaa, Salwa H.; Zaki, A.; El-Attar, Eman; Mokhtar, Mohamed; Swelem, Manal

doi:10.14740/jcgo300w

Cited by 5 publications

(1 citation statement)

References 30 publications

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“…Our related finding among participants eligible to use antihypertensive medication that those using antihypertensive medication had a 37% lower risk of newly reported fibroids, and those using ACE inhibitors in particular had 48% lower risk, is consistent with a recent commercial insurance database study that reported that ACE inhibitor use was associated with 32% reduced odds of new fibroid diagnosis. 22 Preliminary evidence suggests that the renin-angiotensin-aldosterone pathway may explain a protective effect of ACE inhibitors: angiotensin II and aldosterone have been shown to cause fibroid cell proliferation in a rat cell line, 39 , 40 and mixed evidence from human genetic studies 41 suggests that fibroid risk is associated with angiotensin II receptor type 1 genetic sequence variants 42 and angiotensin-converting enzyme insertion-deletion genetic sequence variants. 43 , 44 The renin-angiotensin-aldosterone pathway deserves further exploration in light of our findings suggesting reduction of fibroid risk associated with ACE inhibitors.…”

Section: Discussionmentioning

confidence: 99%

Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife

Mitro,

Wise,

Waetjen

et al. 2024

JAMA Netw Open

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ImportanceFibroids are benign neoplasms associated with severe gynecologic morbidity. There are no strategies to prevent fibroid development.ObjectiveTo examine associations of hypertension, antihypertensive treatment, anthropometry, and blood biomarkers with incidence of reported fibroid diagnosis in midlife.Design, Setting, and ParticipantsThe Study of Women’s Health Across the Nation is a prospective, multisite cohort study in the US. Participants were followed-up from enrollment (1996-1997) through 13 semiannual visits (1998-2013). Participants had a menstrual period in the last 3 months, were not pregnant or lactating, were aged 42 to 52 years, were not using hormones, and had a uterus and at least 1 ovary. Participants with prior fibroid diagnoses were excluded. Data analysis was performed from November 2022 to February 2024.ExposuresBlood pressure, anthropometry, biomarkers (cholesterol, triglycerides, and C-reactive protein), and self-reported antihypertensive treatment at baseline and follow-up visits were measured. Hypertension status (new-onset, preexisting, or never [reference]) and hypertension treatment (untreated, treated, or no hypertension [reference]) were categorized.Main Outcomes and MeasuresParticipants reported fibroid diagnosis at each visit. Discrete-time survival models estimated hazard ratios (HRs) and 95% CIs for associations of time-varying hypertension status, antihypertensive treatment, anthropometry, and biomarkers with incident reported fibroid diagnoses.ResultsAmong 2570 participants without a history of diagnosed fibroids (median [IQR] age at screening, 45 [43-48] years; 1079 [42.1%] college educated), 526 (20%) reported a new fibroid diagnosis during follow-up. Risk varied by category of hypertension treatment: compared with those with no hypertension, participants with untreated hypertension had a 19% greater risk of newly diagnosed fibroids (HR, 1.19; 95% CI, 0.91-1.57), whereas those with treated hypertension had a 20% lower risk (HR, 0.80; 95% CI, 0.56-1.15). Among eligible participants with hypertension, those taking antihypertensive treatment had a 37% lower risk of newly diagnosed fibroids (HR, 0.63; 95% CI, 0.38-1.05). Risk also varied by hypertension status: compared with never-hypertensive participants, participants with new-onset hypertension had 45% greater risk of newly diagnosed fibroids (HR, 1.45; 95% CI, 0.96-2.20). Anthropometric factors and blood biomarkers were not associated with fibroid risk.Conclusions and RelevanceParticipants with untreated and new-onset hypertension had increased risk of newly diagnosed fibroids, whereas those taking antihypertensive treatment had lower risk, suggesting that blood pressure control may provide new strategies for fibroid prevention.

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Section: Discussionmentioning

confidence: 99%

Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife

Mitro,

Wise,

Waetjen

et al. 2024

JAMA Netw Open

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Relationship Among Surgical Fibroid Removal, Blood Pressure, and Biomarkers of Renin–Angiotensin–Aldosterone System Activation

2023

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Uterine fibroids and risk of hypertension: Implication of inflammation and a possible role of the renin‐angiotensin‐aldosterone system

Armanini

Sabbadin

Donà

et al. 2018

J of Clinical Hypertension

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| INTRODUC TI ONHaan and colleagues 1 reported a cross-sectional study on the association between uterine fibroids (UF), hypertension, and asymptomatic organ damage. The major question that arises from this study is, Are UF directly linked to hypertension or is hyper- | ANG I OTEN S IN II AND ALDOS TERONE COMMITMENT IN UFA previous study 8 has found a significant association between A1166C polymorphism in the angiotensin II type 1 receptor (AT1R) gene and UF. Angiotensin II and aldosterone are involved in cell proliferation, angiogenesis, inflammation, and fibrosis. Moreover, angiotensin

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Polymorphisms of Renin Angiotensin System Genes in Uterine Leiomyomas Among Egyptian Females

Cited by 5 publications

References 30 publications

Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife

Hypertension, Cardiovascular Risk Factors, and Uterine Fibroid Diagnosis in Midlife

Relationship Among Surgical Fibroid Removal, Blood Pressure, and Biomarkers of Renin–Angiotensin–Aldosterone System Activation

Uterine fibroids and risk of hypertension: Implication of inflammation and a possible role of the renin‐angiotensin‐aldosterone system

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