NEW YORK (Reuters Health) – Polycystic ovary syndrome (PCOS) does not appear to increase the risk of cardiovascular events among postmenopausal women, researchers from Sweden report in the September 28th online issue of The Journal of Clinical Endocrinology & Metabolism.
“We were very surprised,” Dr. Johanna Schmidt from University of Gothenburg, Goteborg, Sweden told Reuters Health in an email. “Taking into consideration that women with PCOS have a increased prevalence of almost all cardiovascular risk factors during their fertile and perimenopausal ages and that some of the risk factors seem to remain during late postmenopausal ages, we would have expected the women with PCOS to have a higher incidence of cardiovascular events and maybe also a higher mortality than the women without PCOS.”
Dr. Schmidt and colleagues examined cardiovascular risk factors and morbidity/mortality in 32 postmenopausal women with PCOS and in 95 controls matched for body mass index (BMI) and weight.
Triglyceride levels were higher in PCOS women than in controls, but lower LDL levels and higher HDL levels recorded in PCOS women 2 decades earlier were no longer present.
“Our PCOS cohort (and the controls) are fairly lean with a mean BMI of 27.1 kg/m2,” Dr. Schmidt said. “The relatively lean BMI compared to other populations in the world may well be the reason for why the PCOS women only continue to show hypertriglyceridemia and hypertension as CVD risk factors at a late postmenopausal age. Thus, the main message would be to avoid extreme overweight/obesity and to take care of the other risk factors as for women in general.”
There were no significant differences between PCOS women and controls in PAI-1 antigen or fibrinogen levels, in the percentage with diabetes, or in fasting insulin, plasma glucose, and insulin sensitivity.
More PCOS women (22/32, 69%) than controls (39/11358, 41%) had hypertension, although mean systolic and diastolic blood pressure levels were similar in the 2 groups.
There were no significant differences between the groups in cardiovascular events (including myocardial infarction and stroke), breast and reproductive tract malignancy, or overall mortality.
“The nonexistent difference of cardiovascular disease events in PCOS women compared with controls in our study indicates that the traditional cardiovascular disease risk factors may not be fully applicable to a PCOS population,” the researchers note.
“Wild and coworkers showed results in line with our findings in their retrospective registry study in year 2000,” Dr. Schmidt explained. “However, they found a slight increase in cerebrovascular disease in the PCOS women. Since the PCOS population in our study remained to have a higher prevalence of hypertension compared to controls it may be that they in the future will be having more cerebrovascular disease than the controls.”
“We want to extend the PCOS group to a larger group,” Dr. Schmidt added. “We are also now studying bone metabolism and fractures in elderly postmenopausal women.”
Reference:
J Clin Endocrinol Metab 28 September 2011.
