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Coronary Heart Disease Risk Profile in Women Who Underwent Salpingo-Oophorectomy to Prevent Hereditary Breast Ovarian Cancer
  1. Trond Melbye Michelsen, MD*,,,
  2. Serena Tonstad, MD, PhD§,
  3. Are H. Pripp, MSc, PhD,
  4. Claes G. TropÉ, MD, PhD, and
  5. Anne Dørum, MD, PhD,
  1. *Department of Gynecology, Sørlandet Hospital Arendal, Arendal;
  2. National Resource Centre for Women's Health, Rikshospitalet, Oslo University Hospital, and
  3. University of Oslo; and
  4. §Department of Preventive Cardiology, Ullevål,
  5. Biostatistics Unit, Rikshospitalet, and
  6. Department of Gynecologic Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
  1. Address correspondence and reprint requests to Trond Melbye Michelsen, MD, Department of Gynecology, Sørlandet Hospital Arendal, Service Box 605, N-4809 Arendal, Norway. E-mail: trond.melbye.michelsen{at}sshf.no.

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.

  • BRCA1
  • BRCA2
  • Salpingo-oophorectomy
  • Coronary heart disease
  • Framingham risk score
  • Risk factors

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Footnotes

  • The Health Study of Nord-Trøndelag County of Norway is a collaboration between the HUNT Research Centre, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Verdal; Norwegian Institute of Public Health; and Nord-Trøndelag County Council. Trond Melbye Michelsen holds a research career grant from Sørlandet Hospital and the National Resource Centre for Women's Health, Rikshospitalet, Oslo University Hospital.

  • The authors declare that there are no conflicts of interest.

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