Reproductive
Examining the Association Between Endometriosis and Cardiovascular Disease: The Role of Race and Age at Diagnosis of Endometriosis Chidinma Oli* Chidinma Oli Shaira Kee Robert Cook
Background: Endometriosis, a chronic gynecological condition, has been associated to an increased risk of cardiovascular disease (CVD). However, little is known about whether this relationship varies by race or how age at diagnosis influences CVD risk. This study aimed to examine if the association between endometriosis and CVD differs across racial groups and whether the age at endometriosis is associated with CVD risk.
Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999–2006 from women aged 20-54 years who reported an endometriosis diagnosis and self-reported history of CVD (congestive heart failure, coronary heart disease, angina, heart attack, or stroke). Age at endometriosis diagnosis was grouped into 13–29 and 30+ years. Race was categorized as Non-Hispanic White and Black. Multivariable logistic regression with stratified analysis was conducted to assess if the association between endometriosis and CVD varies by race, and whether age at endometriosis is associated with CVD risk, adjusting for age, smoking and education.
Results: Among 3,719 women, 320 (10.3%) reported a diagnosis of endometriosis, with a CVD prevalence of 130 (3.3%). Women with endometriosis had a higher prevalence of CVD (6.7%) compared to those without endometriosis (2.9%, p < 0.0003). Stratified by race, Black women with endometriosis (aOR = 4.5; 95% CI: 2.0–9.9) and White women with endometriosis (aOR = 2.0; 95% CI: 1.0 –3.9) had higher odds of CVD compared to those without. The mean age at endometriosis diagnosis was 29.1 years (IQR: 22.3, 33.9). Women diagnosed at age 30+ had higher odds of CVD compared to those without endometriosis (aOR = 2.7; 95% CI: 1.4–5.2), while no significant difference was observed for those diagnosed at 13–29 (aOR = 1.8; 95% CI: 0.8–4.1).
Conclusion: These findings emphasize the need to consider race and age at endometriosis diagnosis in assessing CVD risk and highlight the importance of targeted intervention