Nonmalignant gynaecological diseases linked to cardiovascular, cerebrovascular disease

Individuals with nonmalignant gynaecological diseases (NMGD) appear to be at increased risk of cardiovascular and cerebrovascular diseases (C/CVD), according to the results of a systematic review and meta-analysis.

Researchers searched multiple online databases for relevant studies. The search yielded 6,639 studies, of which 59 were eligible for full-text review and 28 were included in the analysis. The studies comprised a total study population of 3,271,242 individuals, including 992,475 in at least one NMGD exposure group and 2,278,767 in the unexposed groups.

Composite C/CVD outcome was defined as a combination of ischaemic heart disease, cerebrovascular disease, heart failure, and peripheral vascular disease. Random effects models were used in the analysis, and the ROBINS-I tool was used to evaluate study quality and risk of bias.

Pooled data showed that the risk of composite C/CVD was significantly greater among individuals with an NMGD than among unexposed individuals (summary relative risk [SRR], 1.28, 95 percent confidence interval [CI], 1.20–1.37; n=16 studies, I²=65.3 percent), with low heterogeneity among the studies.

Of note, the risk increase was higher for ischaemic heart disease (SRR, 1.41, 95 percent CI, 1.31–1.51; n=21 studies, I²=73.7 percent) and cerebrovascular disease (SRR, 1.33, 95 percent CI, 1.18–1.51; n=16 studies, I2=91.5 percent).

In NMGD-specific analyses, individuals with a history of endometriosis were at greater risk of C/CVD and its components compared with those with a history of polycystic ovary syndrome.

Most of the studies (53.5 percent) had a “serious” or “critical” risk of bias.