Women who undergo hysterectomies—especially those under 35 years old—are nearly five times more likely to develop congestive heart failure and are at increased risk for a slew of other coronary complications, according to a study of more than 2,000 Minnesota women.

Hysterectomies are common procedures, Shannon K. Laughlin-Tommaso, MD, MPH, and colleagues wrote in the North American Menopause Society’s Menopause, with known cardiac consequences. Prior research has determined the increased chronic and cardiovascular risks associated with removing both the uterus and both of a patient’s ovaries, and in an effort to circumvent those uncertainties many surgeons are opting to leave a woman’s ovaries intact post-procedure.

But these preventive measures don’t erase the danger that comes with the common hysterectomy, Laughlin-Tommaso et al. found. In a retrospective study of 2,094 women in Olmsted County, Minnesota, the researchers discovered women who were 35 years old or younger and underwent a hysterectomy were at increased risks for hypertension, obesity, coronary artery disease, cardiac arrhythmias and de novo hyperlipidemia. The patients, all of whom underwent hysterectomy for benign indications, also saw a 4.6-fold increased risk of congestive heart failure and a 2.5-fold increased risk of coronary artery disease.

These results debunk the concept that leaving a woman’s ovaries intact during a hysterectomy might lower that patient’s chances of developing cardiovascular or chronic disease.

“These study results suggest that alternative uterine-preserving treatments may need to be considered more often in lieu of hysterectomies, especially in benign situations,” NAMS Executive Director JoAnn Pinkerton, MD, said in a release. “For those women having hysterectomy, hormone therapy should be considered for added protection, because ovarian function appears to be impaired by the surgery.”