For decades, cardiovascular disease (CVD) has been thought of as a man’s disease and risk factors have been considered from the male perspective, for example, including erectile dysfunction in guidelines on CVD risk assessment.
Lead study author, Dr Eva Havers-Borgersen from Rigshospitalet Copenhagen University Hospital, Denmark, observed that for decades, CVD has been thought of as a man’s disease and risk factors have been considered from the male perspective, for example, including erectile dysfunction in guidelines on CVD risk assessment.
He said, “Yet, one in three women dies from CVD and one in ten women suffer from endometriosis. Our results suggest that it may be time to routinely consider the risk of CVD in women with endometriosis.”
When this was broken down to the individual components, women with endometriosis had a 20 per cent increased risk of ischemic stroke and 35 per cent increased risk of acute myocardial infarction compared with those without endometriosis.
Moreover, women with endometriosis also had an increased risk of arrhythmias and heart failure compared with those without endometriosis.
Growing evidence suggests there is a close relationship between endometriosis and the cardiovascular system and that they may share common disease pathways.
Havers-Borgersen stated that “although the absolute differences were small, the relative differences were 20 per cent, and with the high prevalence of endometriosis, these results provide more evidence that female-specific risk factors and CVD in women need greater attention.
“We suggest that women with endometriosis undergo CVD risk assessment, and it is now time for female-specific risk factors – such as endometriosis, but also gestational diabetes and pre-eclampsia – to be considered in cardiovascular risk prediction models.”
The study used Danish nationwide registries of all women with a diagnosis of endometriosis between 1977 and 2021. They were matched with women from the background population without endometriosis in a 1:4 ratio based on year of birth.
The primary outcome was a composite of acute myocardial infarction and ischemic stroke. The secondary outcomes were the individual components of the primary outcome, as well as arrhythmias, heart failure and mortality.
There were 60,508 women with endometriosis and 242,032 matched controls included in the analysis (median age, 37.3 years) that were followed for a median of 16 years and a maximum of 45 years.
The research presented at the European Society of Cardiology (ESC) Congress 2024, showed that women with endometriosis had a 20 per cent increased risk of the composite endpoint of acute myocardial infarction and ischemic stroke compared with those without endometriosis.
Growing evidence suggests there is a close relationship between endometriosis and the cardiovascular system and that they may share common disease pathways, Havers-Borgersen added.
Although the absolute differences were small, the relative differences were 20per cent, and with the high prevalence of endometriosis, these results provide more evidence that female-specific risk factors and CVD in women need greater attention.
“We suggest that women with endometriosis undergo CVD risk assessment, and it is now time for female-specific risk factors – such as endometriosis, but also gestational diabetes and pre-eclampsia – to be considered in cardiovascular risk prediction models. Further research is needed to confirm our findings and integrate these factors into effective risk prediction models.”
