Endometriosis linked to increased CVD risk

Women with endometriosis face a heightened risk of cardiovascular disease (CVD), particularly coronary heart disease, according to a study.

Researchers used data from the UK Biobank and included 264,740 women (median age 57 years, 75 percent postmenopausal) without CVD in the analysis. Outcomes were CVD (a composite of fatal and nonfatal coronary heart disease, peripheral artery disease, and stroke), cardiovascular mortality, and all-cause mortality.

Of the women, 8,194 had endometriosis. Women with vs without endometriosis tended to be younger (53 vs 57 years), already be in menopause (80 percent vs 75 percent), and have had a hysterectomy (58 percent vs 17 percent) or oophorectomy (37 percent vs 7 percent).

Over 3,484,788 person‐years of follow‐up, CVD occurred in 22,283 women. The risk of CVD was 18 percent higher among women with vs without endometriosis (hazard ratio [HR], 1.18, 95 percent confidence interval [CI], 1.10–1.28). This risk increase was primarily driven by coronary heart disease (HR, 1.24, 95 percent CI, 1.12–1.37).

Conversely, endometriosis was associated with a 12-percent lower risk of all‐cause mortality (HR, 0.88, 95 percent CI, 0.80–0.98). The association with cardiovascular mortality was null (HR, 0.85, 95 percent CI, 0.63–1.13).

In mediation analysis, hysterectomy partially mediated the association between endometriosis and CVD.

Results were consistent in subgroup analyses.

More studies are needed to establish whether hysterectomy may proxy endometriosis severity instead of being a true mediator, the researchers said.