Endometriosis Linked to Increased Risk for Heart Disease

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Women with endometriosis — particularly those aged 40 and under — face increased risk for coronary heart disease (CHD), according to a prospective study in Circulation: Cardiovascular Quality and Outcomes.

In the Nurses' Health Study II, over 116,000 women aged 25 to 42 without histories of CHD or stroke were followed for roughly 20 years. During that time, nearly 1500 experienced CHD. After multivariable adjustment, women with laparoscopically confirmed endometriosis — compared to those without it — had increased risks for myocardial infarction (relative risk, 1.52), angina (RR, 1.91), and coronary surgery (1.35).

Relative risks were highest in the youngest women. In addition, greater frequency of hysterectomy and oophorectomy accounted for 42% of the increased CHD risk in those with endometriosis.

The researchers note that "endometriosis has been linked to systemic chronic inflammation, heightened oxidative stress, and an atherogenic lipid profile." Dr. Andrew Kaunitz, editor-in-chief of NEJM Journal Watch Women's Health, adds that the findings suggest that "women with this relatively common gynecologic condition may warrant extra attention to lifestyle and other cardiovascular risk factors."