Endometriosis and long-term cardiovascular risk: a nationwide Danish study

Eva Havers‐Borgersen, Dorthe Hartwell, Hartwell D, Charlotte Ekelund, C. K. Ekelund, Jawad H. Butt, Lauge Østergaard, Holgersson C, Christine Holgersson, Morten Schou, Lars Køber, Fosbøl EL, Emil Loldrup Fosbøl, Emil L Fosbøl
European heart journal · 2024 · vol. 45(44) , pp. 4734–4743 · doi:10.1093/eurheartj/ehae563 · PMID:39219447 · W4402135052
Observational OA: bronze CC0 ⤵ 10 in-corpus citations
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Women with endometriosis have an increased long-term risk of cardiovascular outcomes, including myocardial infarction, ischemic stroke, arrhythmias, and heart failure, but a decreased risk of mortality compared to matched controls.

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Abstract

BACKGROUND AND AIMS: Endometriosis, a systemic gynaecological disease affecting 10% of women in reproductive age, shares pathophysiological characteristics with cardiovascular disease. However, data on the relationship between endometriosis and cardiovascular outcomes are scarce, prompting this study to address the knowledge gap. METHODS: Using Danish nationwide registries, women diagnosed with endometriosis (1977-2021) were identified and matched with controls in a 1:4 ratio based on year of birth. The primary outcome was a composite of acute myocardial infarction and ischaemic stroke. The secondary outcomes were arrhythmias, heart failure, and mortality. RESULTS: In total, 60 508 women with endometriosis and 242 032 matched controls were included (median age 37.3 years). Women with endometriosis were more comorbid and used more medications than controls. The incidence rates of the composite outcomes were 3.2 [95% confidence interval (CI) 3.2-3.3] and 2.7 (95% CI 2.7-2.8) per 1000 person-years among women with and without endometriosis, respectively. Women with endometriosis had a significantly higher associated rate of the composite outcome compared with controls [unadjusted hazard ratio (HR) 1.18 (95% CI 1.14-1.23), adjusted HR 1.15 (95% CI 1.11-1.20)]. Likewise, women with endometriosis were also at significantly increased associated risk of arrhythmias [unadjusted HR 1.24 (95% CI 1.20-1.28) and adjusted HR 1.21 (95% CI 1.17-1.25)] and heart failure [unadjusted HR 1.16 (95% CI 1.09-1.22) and adjusted HR 1.11 (95% CI 1.05-1.18)] but at decreased risk of mortality [unadjusted HR 0.95 (95% CI 0.92-0.97) and adjusted HR 0.93 (95% CI 0.91-0.96)]. CONCLUSIONS: Women with endometriosis have a higher associated long-term risk of cardiovascular outcomes compared with controls. Despite subtle absolute risk differences, the high prevalence of endometriosis underscores the importance of these findings.

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Condition tags

endometriosis

MeSH descriptors

Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases Cardiovascular Diseases

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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