Risk of cardiovascular disease and mortality among women with endometriosis: A systematic review and meta-analysis
Abstract
Introduction: Endometriosis is a chronic and estrogen-dependent disorder that affects about 10% of women of reproductive age worldwide. Endometriosis has been associated with chronic inflammation and an atherogenic lipid profile, two conditions that increase the risk of atherothrombotic cardiovascular diseases.
Material and methods: A literature search for relevant studies published from the earliest record to 31 March 2025 was conducted in MEDLINE and EMBASE databases. The following MESH terms were searched: "stroke," "cerebrovascular disease," "cardiovascular disease," "coronary heart disease," "ischemic heart disease," "mortality," and "endometriosis." The results of each study were pooled, and an overall estimate of relative risk was obtained with a random-effect model. Homogeneity between studies was analyzed using I2 statistics. This review was not registered.
Results: Ten studies were eligible for inclusion in this meta-analysis. Five studies reported an increased risk of stroke with endometriosis, with a pooled risk of 1.18 (95% confidence intervals [95% CI] [1.13-1.22]). Four studies reported an increased risk of coronary heart disease with endometriosis, with a pooled risk of 1.36 (95% CI [1.32-1.40]). Four studies reported an increased risk of composite cardiovascular disease with endometriosis, with a pooled risk of 1.16 (95% CI [1.12-1.20]). Although the homogeneity is high in results, the confounding factors considered in the different studies vary. Thus, these…
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