Endometriosis and higher risk of a heart disease – new dependencies

iStock_000024649569XSmallAmerican scientists report that women with endometriosis, who are 40 years old and less, are under greater risk of coronary heart disease. The results of the study were published in Circulation Cardiovascular Quality and Outcomes.

Endometriosis is a chronic and estrogen-dependent gynecological disorder that affects approximately 10% of women in reproductive age in the United States. The disease involves the presence of the mucosa cells of the uterus outside the uterine cavity, primarily in the pelvic peritoneum and ovaries. The symptoms of the disease include chronic pelvic pain, dysmenorrhea, dyspareunia and reduced fertility. Numerous scientific reports indicate that endometriosis is associated with chronic systemic inflammation, elevated oxidative stress and atherogenic lipid profile. In women with endometriosis, there is an increase in inflammatory cytokines: IL-1, IL-6, TNF-α both in peripheral blood and in the peritoneal fluid.

US researchers examined the prospective association between coronary heart disease and endometriosis among 116.430 women participating in the Nurses’ Health Study II. Endometriosis was confirmed by laparoscopy. Patients with a history of heart disease or stroke were excluded. The study was attended by nurses aged 25 to 42 years residing in the United States and registered in 1989.

After 20 years of observation, researchers learned that women with endometriosis required 1.35 times more cardiac intervention compared to women without endometriosis. Moreover, women with endometriosis required 1.35 times more stenting of blocked arteries and were 1.52 times more likely to have a heart attack and 1.91 times more likely to develop angina.

What’s more, the researchers found out that women with endometriosis were three times more likely to develop a heart attack, angina or were more likely to require surgical treatment of blocked arteries, compared to women without endometriosis.

Dr. Fan Mu, the main author of this study, former research assistant at Brigham and Women Hospital and Harvard Medical School in Boston where the study was conducted, points out, that women with endometriosis should be aware of the increased risk of developing heart disease at young age.

Moreover, the scientists noticed that hysterectomy or oophorectomy may partially increase the risk of heart disease. A surgically induced menopause before its natural appearance may increase the risk as well and it may be more visible at young age. This trend has been observed in 42% of cases.

Dr. Stacey A. Missmer, director of epidemiological studies in Reproductive Medicine at Brigham and Women Hospital, emphasizes the importance of healthy habits, cardiac control and knowledge about the symptoms of heart disease in patients with endometriosis, especially the young patients. He stresses that heart diseases are the most frequent death cause among women.

Despite some study limitations, eg. a lack of assessment of the effects of certain hormonal treatments for endometriosis, researchers agree that in a large number of patients, the duration of observation and the ability of taking into account multiple risk factors for heart disease prove strength of their findings.

The results of the research have implications for the clinical treatment of patients with endometriosis. Suggesting that women with this disease may represent a high risk group for heart disease, especially at a young age, the results indicate the need for awareness of this risk and taking this group of people for screening for coronary artery disease. The results also oblige primary care physicians and public health professionals to promote healthy lifestyle among their patients .

Written by: Agata Zwierz, Klaudia Zyzak, Katarzyna Gałaszkiewicz.

Source:
1. Fan Mu, Janet Rich-Edwards, Eric B. Rimm, Donna Spiegelman, Stacey A. Missmer. Endometriosis and Risk of Coronary Heart Disease. Circulation: Cardiovascular Quality and Outcomes, 2016
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Would You like to know more? Watch on MEDtube.net: Endometriosis Located In The Thorax

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