Hypertension Improvement Following total Abdominal Hysterectomy in Women with Adenomyosis: A Prospective Cohort Study

Abstract

Background: Adenomyosis is gynecological uterine disease that is increasingly common among women of reproductive age and characterized by its association with an increased potential of high blood pressure. This study was prepared to evaluate the improvement of hypertension in women with adenomyosis following abdominal total hysterectomy.

Methods: The prospective cohort study involved (110) patients with adenomyosis underwent total abdominal hysterectomy, (76) of whom had a history of hypertension, in private hospitals in Diyala Governorate, Iraq, between February and October 2025. Then, after six months of post-operative follow-up, changes in blood pressure readings and medication dosages were assessed.

Results: It was observed that 54 women (71.1%) experienced remarkable improvement in their blood pressure levels, with 35 (64.8%) showing clinical improvement and 19 (35.2%) achieving complete or normal blood pressures, associated with younger age, had hypertension for less than two years, not obese, and without family history of hypertension . In contrast, 22 women (28.9%) did not experience any marked improvement in hypertension associated with older women, obese, a family history of hypertension, and had hypertension for long periods exceeding 6 years.

Conclusion: A total hysterectomy may be considered an option for improving or normalizing the high blood pressure in women with adenomyosis, especially in the absence of other precipitating risk factors.