Project 415499

Cardiovascular disease (CVD), a class of conditions affecting the heart and blood vessels in the body, remains the leading cause of premature death for women in Canada. Unfortunately, women with CVD are underdiagnosed and experience worse prognosis compared to men. This is likely due to the fact that much of many of the diagnostic and treatment strategies are based on research performed preferentially in men. There is an urgent need to reduce CVD in women, which requires recognition of CVD risk factors specific to women. In 2016, the Nurses' Health Study II became the first study to suggest an association between endometriosis, a female specific disease, and CVD. Endometriosis is a chronic condition of pelvic pain affecting up to 10% of the female population. Although it is known as a gynecologic condition, it is becoming clear that endometriosis leads to chronic inflammation and oxidative stress in multiple organ systems. Furthermore, women with endometriosis are more likely to receive surgical and medical management which lead to early menopause - an independent risk factor for CVD. We hypothesize that women with endometriosis are at an increased risk of developing CVD. To investigate these hypothesis, we will use a population-based approach to determine the association between a diagnosis of endometriosis and subsequent risk of CVD. We plan to conduct a retrospective cohort study using data sets from the Institute of Clinical Evaluative Sciences (ICES) in Ontario. Secondly, we will use a biometric approach, including blood tests and other investigations, to assess CVD risk in women with a surgical diagnosis of endometriosis and age matched controls. It is important to investigate if patients with endometriosis are at increased risk of CVD. Identifying such patients can allow for implementation of effective prevention strategies to reduce the risk of CVD diagnosis as well as the negative impact of this condition.