Women at risk!
30 Aug 2025
Despite being the leading cause of death, cardiovascular disease (CVD) in women remains under-studied, under-recognised, under-diagnosed and under-treated. Studies presented at ESC Congress 2025 highlight new research into CVD risk in some female-specific conditions.
Yesterday, Mr. Piyush Sajnani (University Hospitals Plymouth NHS Trust - Plymouth, UK) presented findings from a systematic review and meta-analysis investigating whether endometriosis is associated with increased risk of cardiovascular (CV) outcomes. Across seven studies and 1,407,875 participants, women with endometriosis demonstrated a significantly increased risk of major adverse CV events (hazard ratio [HR] 1.15), cerebrovascular disease (HR 1.19), arrhythmias (HR 1.21) and ischaemic heart disease (HR 1.35) than women without endometriosis (all p<0.00001), with no significant associations observed for heart failure or all-cause mortality. Mr. Sajnani concluded that there is a “need for robust prospective studies to validate these associations and to explore underlying mechanisms.”
A session in the Research Gateway this afternoon will explore other conditions associated with increased CV risk in women. Doctor Eva Havers-Borgersen (Rigshospitalet - Copenhagen University Hospital - Copenhagen, Denmark) will present an analysis of Danish nationwide registries assessing the risk of a composite of acute myocardial infarction (MI) and ischaemic stroke in women with polycystic ovarian syndrome (PCOS) (n=25,513) compared with matched controls (n=102,052). The 25-year cumulative incidence of the composite endpoint was higher in women with PCOS (3.4%) than controls (2.0%) (adjusted HR 1.53; 95% CI 1.30 to 1.81), underscoring the potential benefits of early CV risk assessment and preventive strategies in women with PCOS.
Data on 291 cases of sudden cardiac arrest in pregnancy, collected by the Lancet Commission Research Consortium on Sudden Death, will be presented by Doctor Orianne Weizman (European Georges Pompidou Hospital - Paris, France). The incidence of sudden death in pregnancy was estimated to be 0.98 cases per million women, with most cases (56.7%) occurring without prior CVD history or risk factors. The cause was established in around three-quarters of cases and was attributed to CVD in around half of these known-cause cases (n=108), notably structural non--schaemic heart disease (50.0%), ischaemic (24.1%), vascular causes (18.5%) and electrical heart diseases (3.7%). Further studies are needed to understand how this rare but devastating condition can be prevented.
Today’s session will also include a presentation by Doctor Simone Marschner (University of Sydney - Sydney, Australia) on the global prevalence of early menopause and its association with CV outcomes from the global PURE study. In a cohort of 113,315 women from 26 countries, women from the lower socio-economic regions were found to reach menopause earlier. Menopause age also differed by region, with half of the African participants reaching menopause by the age of 48.3 years compared with 50.9 years in Europe. HRs for CV death for women with premature (<40 years), early (40 to <45 years) and common (≥45 years) menopause were 1.5, 1.4 and 1.2, respectively, compared with no menopause, indicating increased risk of adverse outcomes with early menopause.
Head to Science Box 4 in the Research Gateway today to find out more about these presentations and also to learn about clinical aspects of Brugada syndrome in females, sex differences in the effects of heart failure treatments and the pathophysiological basis of angina symptoms in women with non-obstructive atherosclerosis.
