Coronary heart disease risk profile in women who underwent salpingo-oophorectomy to prevent hereditary breast ovarian cancer.
BACKGROUND
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.
Michelsen
Trond Melbye
TM
Department of Gynecology, Sørlandet Hospital Arendal, Arendal, Norway. trond.melbye.michelsen@sshf.no
Tonstad
Serena
S
Pripp
Are H
AH
Tropé
Claes G
CG
Dørum
Anne
A
D000328:Adult; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood / Q000453:epidemiology*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D010051:Ovarian Neoplasms / Q000517:prevention & control*; D010052:Ovariectomy; D018570:Risk Assessment