In a new study, women with laparoscopically confirmed endometriosis had a greater risk for angina, MI and/or need for CABG surgery, coronary angioplasty or stents compared with women without endometriosis.
Previous research has demonstrated an association between endometriosis and CHD risk, especially women aged 40 years or younger at diagnosis who have a three-times-higher risk for CHD events than women of a similar age without endometriosis, according to background information in the study.
“It is important for women with endometriosis — even young women — to adopt heart-healthy lifestyle habits, be screened by their doctors for heart disease, and be familiar with symptoms because heart disease remains the primary cause of death in women,” Stacey A. Missmer, ScD, director of epidemiologic research in reproductive medicine at Brigham and Women’s Hospital, said in a press release.
Using data from the Nurses’ Health Study II, the researchers compared CHD risk in women with and without endometriosis. Of the 116,430 women in the prospective cohort, 11,903 had laparoscopically confirmed endometriosis. During 20 years of follow-up, there were 1,438 combined CHD events.
Women with endometriosis were more likely to need CABG/coronary angioplasty (RR = 1.35; 95% CI, 1.08-1.69) or develop angiographically confirmed angina (RR= 1.91; 95% CI, 1.59-2.29) or MI (RR = 1.52; 95% CI, 1.17-1.98), regardless of any potential confounders. The RR for all endpoints combined was 1.62 (95% CI, 1.39-1.89)
For women aged 40 years or younger, the RR for all combined endpoints was 3.08 (95% CI, 2.02-4.7), with the risk decreasing as age increased (P = .001).
About 42% of this increased risk for CHD may be due to the surgical removal of the uterus or ovaries, according to the researchers. Among women with endometriosis, those who underwent a hysterectomy/oophorectomy had an increased risk for CHD (RR = 1.51; 95% CI, 1.34-1.71) compared with those who did not. In addition, having surgically induced menopause at an early age seemed to be an important contributor.
“These data have implications for clinical management of endometriosis patients, suggesting that women with endometriosis may represent a high-risk group for CHD — particularly at a young age, indicating the need for risk awareness and subsequent screening for CHD and healthy lifestyle promotion among primary care and public health specialists,” the researchers wrote.
Disclosure: The study was funded by research grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The researchers report no relevant financial disclosures.