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Vasectomy and subsequent cardiovascular disease in US physicians

  • JoAnn E Manson
    Correspondence
    Name and address for correspondence: JoAnn E. Manson, MD, Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Avenue East, Boston, MA 02215-1204; Tel.: (617) 278-0871; Fax: (617) 232-3541
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts, USA
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  • Paul M Ridker
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA
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  • Angela Spelsberg
    Affiliations
    Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
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  • Umed Ajani
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA
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  • Paulo A Lotufo
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA
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  • Charles H Hennekens
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Massachusetts, USA

    Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
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      Abstract

      Due to previous animal research suggesting accelerated atherosclerosis following vasectomy, we examined whether vasectomy increases the risk of subsequent cardiovascular disease (CVD), including myocardial infarction (MI), angina pectoris, coronary revascularization, and stroke, in the US Physicians’ Health Study. Of 22,071 US male physicians participating in the study, aged 40 to 84 years at entry and free from cardiovascular disease and cancer, 21,028 reported on the 60-month questionnaire whether they had undergone vasectomy prior to randomization. Of the 4546 physicians with vasectomy, 1159 had undergone the procedure at least 15 years before entry. During 258,892 person-years of follow-up, we documented 773 cases of MI (719 nonfatal and 54 fatal), 1907 cases of angina pectoris or coronary revascularization, and 604 confirmed cases of ischemic or hemorrhagic stroke (566 nonfatal and 38 fatal). When compared to men without prior vasectomy, the multivariate relative risk (RR) of total MI adjusted for age and other coronary risk factors was 0.94 (95% confidence interval [CI], 0.77–1.14) among men with vasectomy. Risk estimates for fatal and nonfatal events did not appreciably differ from each other. For angina or coronary revascularization or both, the multivariate relative risk was 0.99 (0.88–1.12) and for total stroke the RR was 0.95 (0.75–1.21). For men who had undergone vasectomy 15 or more years previously, the multivariate relative risks were 0.98 (0.73–1.32) for total MI, 1.17 (0.87–1.57) for total stroke, and 1.12 (0.94–1.35) for angina/revascularization. These results provide reassuring evidence that vasectomy does not materially increase the risk of subsequent cardiovascular disease, even 15 or more years following the procedure.

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