Coronary heart disease risk profile in women who underwent salpingo-oophorectomy to prevent hereditary breast ovarian cancer

Int J Gynecol Cancer. 2010 Feb;20(2):233-9. doi: 10.1111/igc.0b013e3181ca5ff4.

Abstract

Introduction: We examined coronary heart disease risk profile in women from hereditary breast ovarian cancer families who had undergone risk-reducing salpingo-oophorectomy and compared the results to that of controls from the general population.

Methods: A sample of 326 (65% of invited) women with previous risk-reducing salpingo-oophorectomy after genetic counseling provided data and blood samples (cases). Controls were 1630 age-matched women from a Norwegian population-based health study. We examined the coronary heart disease risk profile and the Framingham risk score in both groups.

Results: The cases had a lower mean (SD) Framingham total score compared to the controls (12.9 [5.1] vs 14.5 [5.2]; P = 0.02). Except for a wider waist circumference, the cases had a more favorable coronary heart disease risk profile including more physical activity, lower levels of total cholesterol, higher levels of high-density lipoprotein cholesterol, lower systolic blood pressure, and lower body mass index compared with the controls. In multivariate logistic regression analyses, the risk-reducing salpingo-oophorectomy group was inversely associated with a Framingham 10-year risk score of 5% or higher (odds ratio, 0.49; 95% confidence interval, 0.34-0.71; P < 0.001). Lower levels of education, not having paid work, a history of stroke, and a wider waist circumference were significantly associated with a Framingham risk score higher than 10% in the total sample.

Conclusions: Self-selection of women seeking risk-reducing salpingo-oophorectomy, changes in lifestyle after surgery, and survival bias may explain that the women who underwent risk-reducing salpingo-oophorectomy had a more favorable coronary heart disease risk profile compared with the controls. Longitudinal studies are needed to further clarify the associations observed in this cross-sectional study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Coronary Disease / blood
  • Coronary Disease / epidemiology*
  • Fallopian Tubes / surgery
  • Female
  • Humans
  • Middle Aged
  • Norway / epidemiology
  • Ovarian Neoplasms / prevention & control*
  • Ovariectomy*
  • Risk Assessment