Risk of Ischemic Heart Disease Associated with Primary Dysmenorrhea: A Population-Based Retrospective Cohort Study

Chung-Hsin Yeh; Chih-Hsin Muo; Fung-Chang Sung; Pao-Sheng Yen

doi:10.3390/jpm12101610

Risk of Ischemic Heart Disease Associated with Primary Dysmenorrhea: A Population-Based Retrospective Cohort Study

J Pers Med. 2022 Sep 29;12(10):1610. doi: 10.3390/jpm12101610.

Authors

Chung-Hsin Yeh^{1

2}, Chih-Hsin Muo³, Fung-Chang Sung^{3

4

5}, Pao-Sheng Yen⁶

Affiliations

¹ Department of Nursing, College of Nursing and Health, Da-Yeh University, Changhua 51500, Taiwan.
² Department of Neurology, Yuan Rung Hospital, Changhua 51045, Taiwan.
³ Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan.
⁴ Department of Health Services Administration, China Medical University College of Public Health, Taichung 40447, Taiwan.
⁵ Department of Food Nutrition and Health Biotechnology, Asia University, Taichung 41354, Taiwan.
⁶ Department of Neuroradiology, Kuang Tien General Hospital, Taichung 43303, Taiwan.

Abstract

The awareness on ischemic heart disease (IHD) in women with dysmenorrhea is insufficient. We utilized the National Health Insurance Research Database (NHIRD) of Taiwan to evaluate this relationship. From the claims data, we established a cohort of women aged 15-50 years with primary dysmenorrhea diagnosed from 2000 to 2008 (n = 18,455) and a comparison cohort (n = 36,910) without dysmenorrhea, frequency matched by age and diagnosis date. Both cohorts were followed until the end of 2013 to assess IHD events. With 75% of study population aged 15-29 years, the incidence of IHD was greater in the dysmenorrheal cohort than in the comparison cohort (1.93 versus 1.18 per 10,000 person-years), with an adjusted hazard ratio of 1.60 (95% confidence interval [CI] = 1.38-1.85). The incidence increased with age and the rate of increase was greater in the dysmenorrheal cohort than the comparison cohort. Nested case-control analysis in the dysmenorrhea cohort showed that IHD risk was also associated with hypertension and arrhythmia, with adjusted odds ratios of 2.50 (95% CI = 1.64-3.81) and 3.30 (95% CI = 2.25-4.86), respectively. Women with dysmenorrhea are at a higher risk of developing IHD, particularly for older patients and patients with comorbidity.

Keywords: claims data; dysmenorrhea; ischemic heart disease; nested case-control study; retrospective cohort study.

Grants and funding

This study is supported in part by Ministry of Health and Welfare Clinical Trial Center (MOHW110-TDU-B-212-124004) and Ministry of Science and Technology (MOST 110-2321-B-039-003), and China Medical University Hospital (DMR-111-228). The funders have no role in the study design, data collection and analysis, the decision to publish, or preparation of the manuscript.