The cardiovascular risk profile of middle‐aged women with polycystic ovary syndrome

Meun, Cindy; Gunning, Marlise N.; Louwers, Yvonne V.; Peters, Henrike E.; Roos‐Hesselink, Jolien W.; Lennep, Jeanine Roeters van; Ochoa, O. Rueda; Appelman, Yolande; Lambalk, Cornelis B.; Boersma, Eric; Kavousi, Maryam; Fauser, Bart C.J.M.; Laven, Joop S.E.; Baart, Sara J.; Benschop, Laura; Brouwers, Laura; Budde, Ricardo P.J.; Cannegieter, Suzanne C.; Dam, Veerle; Eijkemans, René; Ferrari, Michel; Franx, Arie; Groot, Christianne de; Hoek, Annemieke; Koffijberg, Hendrik; Koster, Wendy; Kruit, Mark C.; Lagerweij, Giske; Linstra, Katie M.; Lugt, Aad van der; Maas, Angela H.E.M.; Brink, Alec Maassen van den; Middeldorp, Saskia; Moons, Karel G.M.; Rijn, Bas B. van; Scheres, Luuk J. J.; Schouw, Yvonne T. van der; Steegers, Eric A.P.; Steegers, Regine; Terwindt, Gisela M.; Velthuis, Birgitta K.; Wermer, Marieke J.H.; Zick, Bart; Zoet, Gerbrand A.

doi:10.1111/cen.14117

Cited by 43 publications

(29 citation statements)

References 40 publications

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“…Several cardiovascular risk factors associated with PCOS seem to ameliorate over time. 224 In a meta-analysis performed for the development of the ESHRE/American Society for Reproductive Medicine guidelines on PCOS, and restricted to only higher quality studies, no increased risk of MI, stroke or CAD was found in women with PCOS compared to controls. 225–227 Another meta-analysis confirmed that the risk of CVD was increased in women of reproductive age, but not in peri- or post-menopausal women.…”

Section: Hormonal Dysregulation and Cardiovascular Disease Riskmentioning

confidence: 99%

Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists

Maas

Rosano

Cífková

et al. 2021

European Heart Journal

196

128

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Women undergo important changes in sex hormones throughout their lifetime that can impact cardiovascular disease risk. Whereas the traditional cardiovascular risk factors dominate in older age, there are several female-specific risk factors and inflammatory risk variables that influence a woman’s risk at younger and middle age. Hypertensive pregnancy disorders and gestational diabetes are associated with a higher risk in younger women. Menopause transition has an additional adverse effect to ageing that may demand specific attention to ensure optimal cardiovascular risk profile and quality of life. In this position paper, we provide an update of gynaecological and obstetric conditions that interact with cardiovascular risk in women. Practice points for clinical use are given according to the latest standards from various related disciplines (Figure 1).

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Section: Hormonal Dysregulation and Cardiovascular Disease Riskmentioning

confidence: 99%

Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists

Maas

Rosano

Cífková

et al. 2021

European Heart Journal

196

128

View full text Add to dashboard Cite

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“…Hyperandrogenaemia has been associated with adverse health consequences in young women 14 . However, Meun et al have reported that the prevalences of dyslipidaemia, insulin resistance, type 2 diabetes, metabolic syndrome, evidence of atherosclerosis and cardiovascular disease do not appear to differ between women at midlife with a prior diagnosis of polycystic ovary syndrome (PCOS) than age‐matched controls, despite BMI, systolic blood pressure and androgen concentrations being higher in the women with prior PCOS 15 . An important question is whether the restoration of T concentrations in older women to concentrations seen in premenopausal women, along with the increase in T over 3 years observed in over 50% of the women aged 70–79 years from baseline offers any survival advantage.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal changes over three years in sex steroid hormone levels in women aged 70 years and over

Islam

Bell

Handelsman

et al. 2021

Clinical Endocrinology

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Objective Sex steroid levels in women vary with increasing age from the age of 70 years (70+). Whether this reflects change within individuals with age or a survival advantage is not known. This study aimed to determine the stability of circulating sex steroids and SHBG over time in individual women aged 70+. Design A prospective cohort study. Participants 400 women, aged 70+ not using any sex steroid, anti‐androgen/oestrogen or glucocorticoid therapy. Main outcome measurements Sex steroid concentrations, measured by liquid chromatography‐tandem mass spectrometry and sex hormone‐binding globulin (SHBG) by immunoassay, in paired blood samples drawn 3 years apart and analysed together. Results 400 women, median (IQR) age 78.0 (8.6) years, were included in the analysis. Mean testosterone concentrations were statistically significantly higher in follow‐up samples compared with baseline. The change was modest (mean change 31 pmol/L, 95% confidence interval (CI) 2.4–59.8; p = .034), and an increase was not observed in all women. There was a statistically significant decline in mean body mass index (mean change −0.4 kg/m2, 95% CI 0.6 to −0.3; p < .001) and a significant increase in the mean serum SHBG concentration (mean change 4.0 nmol/L, 95% CI 2.7–5.4; p < .001). The change observed in testosterone was not explained by the observed change in SHBG. There was no significant change in the mean oestrone or dehydroepiandrosterone concentration. Conclusions Testosterone concentrations in women aged 70+ were more likely to increase than decrease. Whether increasing testosterone concentrations in older women confer a survival advantage needs investigation.

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“…The Study of Women’s Health Across the Nation (SWAN) study indicated no association between a history of HA or menstrual irregularity and impairment of metabolic condition after menopause ( 33 ). Meun et al ( 28 ) did not observe significant difference in the prevalence of MS between women with PCOS and controls at the age of 50. Overall, women with PCOS experience a higher risk of MS during the reproductive period.…”

Section: Metabolic Syndromementioning

confidence: 92%

“…Although several studies and meta-analyses showed a higher prevalence of overweight and obesity in women with PCOS than in women without PCOS, the data in aging women with PCOS are insufficient ( 9 , 27 ). Meun et al ( 28 ) recently observed higher body mass index (BMI) values and increased waist circumferences in women with PCOS aged >45 years than in healthy controls. Wild et al ( 29 ) reported significantly higher BMI and waist-to-hip ratio (WHR) values in a PCOS group than in a control group in a 31-year follow-up study.…”

Section: Obesitymentioning

confidence: 99%

An overview of polycystic ovary syndrome in aging women

Çelik

Köse

2021

J Turkish German Gynecol Assoc

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The manifestations of polycystic ovary syndrome (PCOS), a ubiquitous reproductive disorder, may vary significantly depending on the severity of a number of endocrine and metabolic changes. Although no diagnostic criteria are presently available for PCOS for perimenopausal and menopausal women, the condition can still be suspected in case of a previous diagnosis of the condition, a chronic history of irregular menstrual cycles and hyperandrogenism, and/or polycystic ovarian morphology during the reproductive period. PCOS is associated with long-term health risks, including obesity, diabetes, hypertension, dyslipidemia, metabolic syndrome and cardiovascular risk factors during reproductive age, especially in patients possessing classic phenotypes. The aim of this review was to outline the available data about the impact of PCOS on long-term health risks after reproductive age in patients with PCOS. Previously, it was assumed that women with PCOS would be more prone to develop cardiometabolic diseases after reproductive age but current data suggest that in accordance with the healing in the phenotypic characteristics of PCOS, no deterioration appears to occur in cardiometabolic health in these patients. While there is substantial evidence for a greater prevalence of abnormal subclinical atherosclerotic markers among younger patients with PCOS, data for older women are insufficient. However, there is also support for an increased risk of endometrial cancer in PCOS patients. Extensive prospective cohort studies in which healthy controls as well as patients with defining PCOS phenotypes are observed and monitored from the early reproductive period into the late postmenopausal period should now be performed in order to clarify morbidities and mortality in aging women with PCOS.

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The cardiovascular risk profile of middle‐aged women with polycystic ovary syndrome

Cited by 43 publications

References 40 publications

Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists

Cardiovascular health after menopause transition, pregnancy disorders, and other gynaecologic conditions: a consensus document from European cardiologists, gynaecologists, and endocrinologists

Longitudinal changes over three years in sex steroid hormone levels in women aged 70 years and over

An overview of polycystic ovary syndrome in aging women

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