November 12, 2019
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No evidence for increased long-term CV risk in PCOS

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Middle-aged women with polycystic ovary syndrome exhibit only a moderately unfavorable cardiometabolic profile compared with age-matched controls, although they often present with an increased BMI and waist circumference, according to findings published in Clinical Endocrinology.

“In the past it was assumed that women with PCOS would be more prone to develop cardiovascular disease later in life,” Cindy Meun, a doctoral student in the division of reproductive endocrinology and infertility at Erasmus University Medical Center in Rotterdam, the Netherlands, and colleagues wrote in the study background. “The only available long-term follow-up study in women with PCOS did, however, not reveal an increased risk for CVD. More recent studies in postmenopausal women with features of PCOS seem to reinforce these findings. At the same time, others suggest an increased incidence of CVD in women with PCOS already at an early age. Whether or not women with PCOS are at increased risk to develop CVD still remains uncertain.”

In a cross-sectional study, Meun and colleagues analyzed data from 200 women aged at least 45 years diagnosed with PCOS by Rotterdam criteria and 200 age-matched controls without PCOS from the third cohort of the Rotterdam study, a population-based cohort study focusing on health and disease among older adults (mean age, 51 years). Researchers measured insulin, lipid levels and carotid intima-media thickness to screen for subclinical atherosclerosis and calculated 10-year Framingham risk scores and CV health scores.

Compared with controls, women with PCOS had a greater waist circumference (mean, 93 cm vs. 85.9 cm; P < .001), BMI (mean, 28.4 kg/m²vs. 26.3 kg/m²; P = .015) and higher systolic blood pressure (mean, 130 mm Hg vs. 122 mm Hg; P = .003).

Doctor female patient general 2019 
Middle-aged women with polycystic ovary syndrome exhibit only a moderately unfavorable cardiometabolic profile compared with age-matched controls, although they often present with an increased BMI and waist circumference.
Source: Adobe Stock

In women with PCOS, the prevalence of type 2 diabetes or metabolic syndrome was not significantly increased, and lipid levels were not different from controls. Carotid intima-media thickness was lower among women with PCOS compared with controls (P < .001).

The median 1-year CVD risk was 5.79% for women with PCOS and 7.38% among controls (P = .214). In analyses stratified by level of risk for a CV event over 10 years (low, < 10%; intermediate, 10%-20%; and high, > 20%), the researchers observed no differences in the proportion of women with PCOS and controls in each risk category.

“Studies following women with PCOS until very old age will eventually provide definitive answers on the risk for CVD and the involved mechanisms,” the researchers wrote. “Therefore, cardiovascular assessment and follow-up of women with PCOS is still necessary. At this time, however, we conclude that although some metabolic disturbances were present in our large cohort of middle-aged women with PCOS, we found no evidence for premature atherosclerosis or an increased risk for future CVD. Only time will tell whether this will indeed translate into a better cardiovascular health in women with PCOS than was previously anticipated.” – by Regina Schaffer

Disclosures: Meun reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.