Association Between Endometriosis and Hypercholesterolemia or Hypertension
Open accessAbstract
An altered hormonal or chronic systemic inflammatory milieu characterizing endometriosis may result in a higher risk of hypercholesterolemia and hypertension. Conversely, elevated low-density lipoprotein in hypercholesterolemia and chronic systemic inflammation resulting from hypertension may increase the risk of endometriosis. We assessed the association of laparoscopically confirmed endometriosis with hypercholesterolemia and hypertension in a large prospective cohort study. In 1989, 116 430 registered female nurses aged 25 to 42 completed the baseline questionnaire and were followed for 20 years. Multivariable Cox proportional hazards models were applied. In 1989, there were 4244 women with laparoscopically confirmed endometriosis and 91 554 women without. After adjusting for demographic, anthropometric, family history, reproductive, dietary, and lifestyle risk factors prospectively, comparing women with laparoscopically confirmed endometriosis to women without, the relative risks were 1.25 (95% confidence interval, 1.21–1.30) for development of hypercholesterolemia and 1.14 (95% confidence interval, 1.09–1.18) for hypertension. Conversely, the relative risks of developing laparoscopically confirmed endometriosis were 1.22 (95% confidence interval, 1.15–1.31) comparing women with hypercholesterolemia to women without and 1.29 (95% confidence interval, 1.18–1.41) comparing women with hypertension to women without. The strength of associations of laparoscopically confirmed endometriosis with hypercholesterolemia or hypertension was strongest among women aged ≤40 and weakened as age increased ( P values for interaction <0.001). We observed that ≈45% of the associations between endometriosis and hypercholesterolemia and hypertension could be accounted for by treatment factors after endometriosis diagnosis, including greater frequency of hysterectomy/oophorectomy and earlier age for this surgery. In this large cohort study, laparoscopically confirmed endometriosis was prospectively associated with increased risk of hypercholesterolemia and hypertension. Conversely, hypercholesterolemia and hypertension were prospectively associated with higher risk of laparoscopically confirmed endometriosis.
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The NHS II studies were limited to investigating the association between endometriosis, IHD risk and hypertension risk.
“The NHS II studies were limited to investigating the association between endometriosis, IHD risk and hypertension risk. 30,31”
From Risk of cardiovascular outcomes among women with endometriosis in the United Kingdom: a retrospective matched cohort study (2021) · cites this paper as [31]
The Introduction states that this NHSII study examined associations between endometriosis and hypertension, supporting that part of the claim. It also explicitly examined hypercholesterolemia, so the study was not limited to IHD and hypertension risk; this paper does not report an IHD-risk analysis. (LLM, conf=0.86)
Experimental — accuracy not yet measuredVarious studies have shown that endometriosis is associated with high levels of atherogenic low-density lipoproteins.
“Third, various studies have shown that endometriosis is associated with high levels of atherogenic low-density lipoproteins. 31”
From Risk of cardiovascular outcomes among women with endometriosis in the United Kingdom: a retrospective matched cohort study (2021) · cites this paper as [31]
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- Authors
- Mu, F., Rich-Edwards, J., Rimm, E. B., Spiegelman, D., Forman, J. P., & Missmer, S. A.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Hypertension
- Published
- 2017-07
- Volume
- 70
- Issue
- 1
- Pages
- 59-65
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC6469492
- OpenAlex
- W2620099134
- Cited by
- 180
- References
- 51
- Citations by year
- 2026: 20 · 2025: 30 · 2024: 39 · 2023: 22 · 2022: 18 · 2021: 17 · 2020: 11 · 2019: 12 · 2018: 10
- FWCI
- 10.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- National Institutes of Health
- National Cancer Institute (R01CA050385)
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD057210, R01HD052473)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Keywords
- endometriosis, hypercholesterolemia, chronic systemic inflammation, low-density lipoprotein, hysterectomy, oophorectomy, endometriosis treatment, women's health
- MeSH terms
- Adult, Endometriosis, Female, Humans, Hypercholesterolemia, Hypertension, Inflammation, Prospective Studies, Risk Factors, Statistics as Topic, United States, Cohort Studies, Risk Assessment
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