Cohort studycited by the Tayebat archiveabstract only checked A-ORG-10 standard review
Hysterectomy and heart disease in Sweden
Hysterectomy and risk of cardiovascular disease: a population-based cohort study.
Overview
Ingelsson E et al.. Eur Heart J 2011 · PMID 21186237 · DOI 10.1093/eurheartj/ehq477
Women operated before 50 had about 18% more cardiovascular disease later.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
CVD
- How was the study done?
Register
- How many people, animals or samples were studied?
824,484
- What was actually found?
Higher CVD <50
- How large was the observed effect?
HR 1.18
- What do the results mean in everyday life?
Possible long-term cost
- What are the study's limitations?
Confounding
- What does it say about Elawady's specific claim?
Supports association
- Do the results apply to Germany and Europe?
European
- What can explicitly not be concluded from this study?
Causation
Scientific in-depth review
1. Full reference
- Authors
- Ingelsson E, Lundholm C, Johansson AL, Altman D
- Journal
- Eur Heart J
- Year
- 2011
- Identifier
- PMID 21186237 DOI 10.1093/eurheartj/ehq477
- Verification
- verified – PubMed E-utilities efetch, 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
COI: not stated in record | Grants: none listed
2. Research question
Hysterectomy and later CVD
3. Study design and population
- Study design
- Cohort study – Population-based register cohort
- Population
Swedish women with benign hysterectomy
- Country
Sweden
- Period
1973-2003
- Sample size
184,441 vs 640,043 controls
4. Methods and endpoints
- Exposure / intervention
Hysterectomy +/- oophorectomy
- Comparator
Women without hysterectomy
- Endpoints
Incident CVD
5. Actual results
- Results
Women <50: HR 1.18 (1.13-1.23) without oophorectomy; 2.22 (1.01-4.83) and 1.25 (1.06-1.48) with oophorectomy before/at entry. Women >=50: no significant association.
- Absolute risks
not reported
- Authors' conclusion
Hysterectomy at <=50 years substantially increases CVD risk; oophorectomy adds further.
6. Strengths
- National
7. Weaknesses
- Register confounding (indications, metabolic profile)
8. Risk of bias
- Orienting tool
- ROBINS-E
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
9. Assessment of the statistical interpretation
10. Relevance to the specific claim
Supports C-ORG-10.
11. Independent contrary findings
12. Transferability to Germany and Europe
European.
13. Overall methodological judgement
Association in women <50.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | high |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Hysterectomy (even with ovaries conserved) harms the heart and metabolism; uterus and ovaries form a hormonal network protecting heart, brain and bone. – Studies supporting the claim
- Long-term registry data link removal of tonsils, appendix, gallbladder, uterus, ovaries and spleen to higher rates of respiratory disease, autoimmunity, cardiovascular events, gastrointestinal cancers and dementia; each organ does work the body never fully replaces. – Studies supporting the claim
Use by the Tayebat archive
Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.
- What the archive says about the study
Listed in the archive bibliography only; the archive gives no specific interpretation.
- A. What was actually studied?
Hysterectomy and CVD
- B. What did the authors find?
HR 1.18 in <50
- C. What conclusions do the authors themselves draw?
Increased risk
- D. What does the archive derive from it?
Supports 'hormonal network protects heart'.
- E. Is this derivation scientifically justified?
Supports association in younger women; causal language by authors stronger than design allows.
- Adequacy of the interpretation (by the archive)
- not applicable