Do endometriosis patients have increased risk of stroke?

Endometriosis patients have an increased risk of stroke, a recent prospective study reveals.

Key Points

Highlights:

• Scientific observations suggest that women with endometriosis could have a greater risk of hypertension, hypercholesterolemia, and ischemic heart disease.

Importance:

• Endometriosis may adversely affect cardiometabolic status through alterations in the endogenous inflammatory, immunologic, and hormonal equilibrium.

What’s done here:

• This is a prospective study searching for an association between laparoscopically confirmed endometriosis and incident stroke.
• A time span of 28 years with 2 770 152 person-years of follow-up were evaluated.

Key results:

• Patients with laparoscopically diagnosed endometriosis had a 34% greater risk of stroke, compared to those without endometriosis.
• The largest proportion of this risk was attributed to hysterectomy/oophorectomy and hormone therapy.

Limitations of the study:

• Difficulty in determining the precise onset of endometriosis, the difficulty in differentiation between hemorrhagic and ischemic stroke, and the difficulty in the decision whether endometriosis is more strongly associated with a particular subtype, the cohort in this study being not a random sample of women; hence these findings may not be applicable to the entire population, are the limitations of the study.

Lay Summary

Dr. Leslie V. Farland and colleagues from the University of Arizona, published their prospective research on the risk of stroke in women with laparoscopically confirmed endometriosis in a recent issue of a scientific journal named  “Stroke”.

Endometriosis is a chronic inflammatory gynecologic condition that seems to negatively affect cardiometabolic status through alterations in inflammatory, immunologic, and hormonal milieu. The study aimed to prospectively investigate the association between laparoscopically confirmed endometriosis and the risk of incident stroke during 28 years of a follow-up period.

Participants in the Nurses’ Health Study II which is an ongoing prospective cohort study that began in 1989 when 116429 female registered nurses between the ages of 25 to 42 returned a mailed questionnaire. During 2 770 152 person-years of follow-up, there were 893 cases of stroke. Women with laparoscopically confirmed endometriosis had a 34% greater risk of stroke in multivariable-adjusted models, in comparison to those without a history of endometriosis.

Of the total association of endometriosis with the risk of stroke, the largest proportion was attributed to hysterectomy/oophorectomy (39%) and hormone therapy (16%) There were no differences in the relationship between endometriosis and stroke by age, infertility history, body mass index, or menopausal status.

As a final statement, the authors suggest that as a consequence of these findings clinicians should be aware of the gynecologic and reproductive histories when counseling patients and evaluating cardiovascular risk factors. This attitude will increase the primary prevention of cardiovascular diseases, including stroke.

Research Source: https://pubmed.ncbi.nlm.nih.gov/35861076/