Endometriosis Linked to Increased Risk of Cardiovascular Outcomes

Sarfaroj Khan 


March 12, 2021


  • Endometriosis is associated with an increased risk of composite cardiovascular disease (CVD), ischaemic heart disease (IHD), cerebrovascular disease, arrhythmia and hypertension.

  • No association was found between endometriosis and risk of heart failure (HF).

Why this matters

  • Findings suggest that young women with endometriosis are a potential target group for CVD risk assessment and prevention.

Study design

  • This retrospective cohort study included 56,090 women with endometriosis (age, 16-50 years) and 223,669 matched control participants without endometriosis from The Health Improvement Network (THIN) database, UK.

  • Women aged 16-50 years were followed from 1995 to 2018.

  • Primary outcome was composite CVD including IHD, HF and cerebrovascular disease.

  • Secondary outcomes were arrhythmia, hypertension and mortality.

  • Funding: None.

Key results

  • The annual incidence of endometriosis was 12.3 per 10,000 person-years in 1998 and 11.5 per 10,000 person-years in 2017.

  • The annual prevalence of endometriosis gradually increased from 119.7 per 10,000 population in 1998 to 201.3 per 10,000 population in 2017.

  • Women with endometriosis vs those without were at an increased of (adjusted HR [aHR]; 95% CI):

    • composite CVD (1.24; 1.14-1.37);

    • IHD (1.40; 1.22-1.61);

    • cerebrovascular disease (1.19; 1.04-1.36);

    • arrhythmia (1.26; 1.11-1.43); and

    • hypertension (1.12; 1.07-1.17).

  • No significant association was seen between endometriosis and risk of HF (aHR, 0.76; 95% CI, 0.54-1.07).

  • Women with endometriosis vs those without were at a lower risk of all-cause mortality (aHR, 0.66; 95% CI, 0.59-0.74).


  • Retrospective design.

  • Study could not distinguish surgically confirmed cases from cases diagnosed through other means.


Okoth K, Wang J, Zemedikun D, Thomas GN, Nirantharakumar K, Adderley NJ. Risk of cardiovascular outcomes among women with endometriosis in the United Kingdom: A retrospective matched cohort study. BJOG. 2021 Mar 8 [Epub ahead of print]. doi: 10.1111/1471-0528.16692. PMID: 33683770.  View abstract 

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.


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