Coronary artery disease risk in young women with polycystic ovary syndrome

Abstract

Women with polycystic ovary syndrome are characterized by obesity, menstruation irregularity, hirsutism and infertility, and prevalent with cardiometabolic comorbidities, but population-based studies on the risk of developing coronary artery disease are limited. From claims data of the Taiwan National Health Insurance, we identified 8048 women with polycystic ovary syndrome aged 15-49 years newly diagnosed in 1998-2013, and 32192 women without the syndrome and CAD as controls, frequency matched by age and diagnosis date. By the end of 2013, after a mean follow-up period of 5.9 years, the overall incidence of coronary artery disease was 63% higher in women with polycystic ovary syndrome than in controls (2.25 vs. 1.38 per 1000 person-years). The adjusted hazard ratio [aHR] of coronary artery disease was 1.44 (95% confidence interval (CI) = 1.14–1.81) for women with polycystic ovary syndrome, compared with controls. Hazards of coronary artery disease were significant during follow-up periods of 3-4 years (aHR = 1.52, 95% CI = 1.00–2.30) and of 5–9 years (aHR = 1.58, 95% CI = 1.07–2.32). The incidence of coronary artery disease increased further in those with cardiometabolic comorbidities. Among women with polycystic ovary syndrome, those with comorbid diabetes had an incidence of 35.2 per 1000 person-years, 20-fold greater than those without cardiometabolic comorbidities. In conclusion, women with polycystic ovary syndrome are at an elevated risk of coronary artery disease. Preventive interventions should be provided to them, particularly for those with the comorbidity of metabolism symptom.

Risk of hypertension in women with polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression

“…Search results Figure 1 presents the search strategy and study selection. Of 5236 records retrieved through searching databases 30 studies including 17 population based [2,3,7,19,[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] and 11 non-population based studies [4,5,10,34,[49][50][51][52][53][54][55][56] were selected for the final analyses. Twenty-four studies assessed a population of reproductive age patients with PCOS [2, 3, 5, 7, 10, 34-38, 40, 41, 43-47, 49-51, 53-56], 4 studies-menopausal/aging women [19,39,52,57], and two studies-both age groups of patients (reproductive and menopausal/aging women) [4,48].…”

“…Androgen excess in PCOS may also directly influence the vascular properties of arterial walls and the expression of molecules involved in the atherogenic process [60]. However, contrasting results on the prevalence of hypertension in PCOS have been reported by some studies suggesting increased prevalence [3,7,35,36,38,40,41,43], whereas others find no significant differences in general populations [2,19,39,42,[44][45][46][47].…”

“…dyslipidemia, metabolic syndrome, C-reactive protein are elevated in patients with PCOS [2][3][4][5][6]; these risk factors are present even in young PCOS patients and predispose to development of early atherosclerosis, cardiovascular morbidity and mortality [5,7,8].…”

Hypertension Risk in Young Women With Polycystic Ovary Syndrome: A Nationwide Population-Based Cohort Study

“…Previous studies have demonstrated that almost all cardiovascular risk factors including IR, diabetes mellitus (DM), dyslipidemia, obesity, hypertension, and metabolic syndrome are associated with PCOS (4)(5)(6)(7)(8). These risk factors are present even in young patients with PCOS and predispose to the development of endothelial dysfunction, early atherosclerosis and cardiovascular disease (CVD) (9)(10)(11)(12).…”

Efficacy of different forms of Guizhi Fuling Wan on reproduction and metabolism in women with polycystic ovary syndrome

“…Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disease characterized by menstrual disorder, oligo/anovulation, hyperandrogenemia, polycystic ovaries, and insulin resistance. [ 1 ] Studies [ 2 , 3 ] show that PCOS with complex etiology affects 6% to 15% women of childbearing age, approximately 75% of whom experience infertility due to anovulation. The pathogenesis of PCOS is mostly metabolic disorder caused by insulin resistance and secondary hyperinsulinemia, which can lead to endometrial cancer, cardiovascular disease, type 2 diabetes, and other diseases over time, affecting women's physical, and mental health.…”