A new study found that women with endometriosis may have a higher risk of experiencing heart attacks and strokes.

In a nationwide Danish study presented at ESC Congress 2024, investigators discovered that women with endometriosis had a 20% greater risk of acute myocardial infarction or ischemic stroke compared with women without endometriosis. The study used Danish registries to identify 60,508 women diagnosed with endometriosis between 1977 and 2021, matched 1:4 with 242,032 controls based on birth year.

The median age at inclusion was 37.3 years. Participants were followed for a median of 16 years and maximum of 45 years. Secondary outcomes included the individual components of acute myocardial infarction and ischemic stroke, as well as arrhythmias, heart failure, and mortality.

The primary composite outcome of acute myocardial infarction and ischemic stroke occurred in 17.5% (95% confidence interval [CI] = 16.6–18.2%) of women with endometriosis vs 15.3% (95% CI = 15.0–15.7%) of those without endometriosis over 45 years of follow-up (P < .0001). This translated to an unadjusted hazard ratio (HR) of 1.18 (95% CI = 1.14–1.23) and adjusted HR of 1.15 (95% CI = 1.11–1.20).

Compared with controls, the women with endometriosis also had elevated risks of:

• Ischemic stroke alone (adjusted HR = 1.18, 95% CI = 1.12–1.23)
• Acute myocardial infarction alone (adjusted HR = 1.35, 95% CI = 1.31–1.40)
• Arrhythmias (adjusted HR = 1.21, 95% CI = 1.17–1.25)
• Heart failure (adjusted HR = 1.11, 95% CI = 1.05–1.18).

"Although the absolute risk differences were small, the relative differences of 20%, combined with the high prevalence of endometriosis, provide more evidence that female-specific risk factors and CVD in women need greater attention," said lead study author Eva Havers-Borgersen, of Rigshospitalet Copenhagen University Hospital.

The investigators concluded that women with endometriosis should consider undergoing cardiovascular risk assessment.

The authors declared having no competing interests.