{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T21:56:43Z","timestamp":1789768603599,"version":"4.0.1"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Prior research suggests that women with endometriosis are at greater risk of coronary heart disease. Therefore, our objective was to prospectively investigate the association between laparoscopically confirmed endometriosis and risk of incident stroke during 28 years of follow-up.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              Participants in the NHSII cohort study (Nurses\u2019 Health Study II) were followed from 1989 when they were between the ages of 25 to 42 until 2017 for development of incident stroke (ischemic and hemorrhagic). Cox proportional hazard models were used to calculate hazard ratios and 95% CI, with adjustment for potential confounding variables (alcohol intake, body mass index at age 18, current body mass index, age at menarche, menstrual cycle pattern in adolescence, current menstrual cycle pattern, parity, oral contraceptive use history, smoking history, diet quality, physical activity, NSAID use, aspirin use, race\/ethnicity, and income). We estimated the proportion of the total association mediated by history of hypertension, hypercholesterolemia, hysterectomy\/oophorectomy, and hormone therapy. We also tested for effect modification by age (&lt;50,\n              <jats:italic>\u2265<\/jats:italic>\n              50 years), infertility history, body mass index (&lt;25,\n              <jats:italic>\u2265<\/jats:italic>\n              25 kg\/m\n              <jats:sup>2<\/jats:sup>\n              ), and menopausal status.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>We documented 893 incident cases of stroke during 2\u2009770\u2009152 person-years of follow-up. Women with laparoscopically confirmed endometriosis had a 34% greater risk of stroke in multivariable-adjusted models (hazard ratio, 1.34 [95% CI, 1.10\u20131.62]), compared to those without a history of endometriosis. Of the total association of endometriosis with risk of stroke, the largest proportion was attributed to hysterectomy\/oophorectomy (39% mediated [95% CI, 14%\u201371%]) and hormone therapy (16% mediated [95% CI, 5%\u201340%]). We observed no differences in the relationship between endometriosis and stroke by age, infertility history, body mass index, or menopausal status.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>We observed that women with endometriosis were at elevated risk of stroke. Women and their health care providers should be aware of endometriosis history, maximize primary cardiovascular prevention, and discuss signs and symptoms of cardiovascular disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.122.039250","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T09:00:24Z","timestamp":1658394024000},"page":"3116-3122","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":66,"title":["Laparoscopically Confirmed Endometriosis and Risk of Incident Stroke: A Prospective Cohort Study"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7455-8531","authenticated-orcid":true,"given":"Leslie V.","family":"Farland","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics (L.V.F., W.J.D., M.L.B.), University of Arizona, Tucson."},{"name":"Mel and Enid Zuckerman College of Public Health, and Department of Obstetrics and Gynecology, College of Medicine-Tucson (L.V.F.), University of Arizona, Tucson."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-9790","authenticated-orcid":true,"suffix":"III","given":"William J.","family":"Degnan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics (L.V.F., W.J.D., M.L.B.), University of Arizona, Tucson."},{"name":"Department of Community, Environment, and Policy (W.J.D.), University of Arizona, Tucson."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4821-4094","authenticated-orcid":true,"given":"Melanie L.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics (L.V.F., W.J.D., M.L.B.), University of Arizona, Tucson."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0418-6917","authenticated-orcid":true,"given":"Scott E.","family":"Kasner","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.E.K.), University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0184-6035","authenticated-orcid":true,"given":"Ava L.","family":"Liberman","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine (A.L.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology (D.K.S.), University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3387-8429","authenticated-orcid":true,"given":"Kathryn M.","family":"Rexrode","sequence":"additional","affiliation":[{"name":"Division of Women\u2019s Health, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School (K.M.R.)."},{"name":"Department of Epidemiology, Harvard T.H. 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