Endometriosis and Risk of Coronary Heart Disease

Fan Mu, Janet Rich-Edwards, Janet W. Rich‐Edwards, Eric B Rimm, Donna Spiegelman, Stacey A Missmer
Circulation. Cardiovascular quality and outcomes · 2016 · vol. 9(3) , pp. 257–264 · doi:10.1161/circoutcomes.115.002224 · PMID:27025928 · PMC4940126 · W2326334786
article OA: bronze CC0 ⤵ 128 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Laparoscopically confirmed endometriosis was associated with an increased risk of coronary heart disease, particularly in younger women, with hysterectomy/oophorectomy partially explaining this link.

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Abstract

BACKGROUND: Endometriosis is a prevalent gynecologic disease associated with systemic chronic inflammation, heightened oxidative stress, and atherogenic lipid profile that may increase women's risk for coronary heart disease (CHD). METHODS AND RESULTS: We examined the prospective association between laparoscopically confirmed endometriosis and subsequent CHD among 116 430 women in the Nurses' Health Study II (1989-2009). Participants with a history of heart disease and stroke were excluded. When compared with women without endometriosis, women with laparoscopically confirmed endometriosis had a higher risk of myocardial infarction (relative risk, 1.52; 95% confidence interval, 1.17-1.98), angiographically confirmed angina (1.91; 1.59-2.29), coronary artery bypass graft surgery/coronary angioplasty procedure/stent (1.35; 1.08-1.69), or any of these CHD end points combined (1.62; 1.39-1.89), independent of potential demographic, anthropometric, family history, reproductive, and lifestyle confounders. Relative risk for the combined CHD end point was highest among women aged ≤40 years (3.08; 2.02-4.70) and decreased as age increased (40< age ≤50 years, 1.65; 1.35-2.02; 5055 years, 0.98; 0.56-1.72; P value, test for heterogeneity=0.001). Having had a hysterectomy/oophorectomy was associated with higher risk of combined CHD compared with not having had a hysterectomy/oophorectomy (1.51; 1.34-1.71). A percentage of 42 of the association between endometriosis and CHD could be explained by greater frequency of hysterectomy/oophorectomy and earlier age at surgery after endometriosis diagnosis. CONCLUSIONS: In this large, prospective cohort, laparoscopically confirmed endometriosis was associated with increased risk of CHD. The association was strongest among young women. Hysterectomy/oophorectomy was associated with higher risk of CHD and could partially explain the association between endometriosis and CHD.

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Condition tags

endometriosis

MeSH descriptors

Coronary Disease Endometriosis Adult Age Factors Angina Pectoris Angina Pectoris Coronary Artery Bypass Coronary Artery Disease Coronary Artery Disease Coronary Disease Coronary Disease Coronary Disease Endometriosis Endometriosis Endometriosis Female Humans Hysterectomy Hysterectomy Laparoscopy

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References (56)

Cited by (50)

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