Addy Kirkham
Risk of Heart Disease and Stroke Associated with Primary Ovarian Insufficiency
Authors: Corrine Welt, MD
Department: Internal Medicine- Endocrinology
Abstract
Background: Women with primary ovarian insufficiency (POI) are at risk for cardiovascular disease (CVD) and stroke.
Hypothesis: Subjects diagnosed with POI and their first-, second-, and third-degree relatives have a higher relative risk of CVD and stroke that is heritable.
Methods: We identified women with POI from 1995-2024 thorough ICD codes using University of Utah and Intermountain Healthcare EMR. Relatives were linked using the Utah Population Database. Cases of CVD and stroke were connected to the relatives via ICD codes in the EMR. The relative risk of CVD and stroke were compared to control populations.
Results: 21 of 613 validated cases of POI had associated atherosclerotic heart disease (10) and cerebral infarction (11). We found a 2 fold risk of atherosclerotic heart disease (RR=2.22 [95% confidence interval 1.06-4.08]) and a nearly 3 fold risk of cerebral infarction (RR=2.70 [95% confidence interval 1.35-4.83]). In a smaller cohort (n=416) of women who were linked to three generations of ancestors, stroke was no longer significant. CVD was found to be 16% more likely (RR=1.16 [95% confidence interval 1.03-1.31]) in third degree relatives of those with POI than in the general population.
Conclusion: The data suggest women with POI have an increased risk of CVD and stroke. Their third degree relatives also have a modest but significant increased risk of CVD. This suggests that the increased risk may stem from environmental factors or lack of estrogen rather than genetics.
