Published: Apr 12, 2013
By Cole Petrochko , Staff Writer, MedPage Today

Action Points

• This retrospective study demonstrated that women with polycystic ovary syndrome have a significantly higher prevalence of type 2 diabetes.
• The study also confirms that these women have a higher prevalence of cardiovascular events such as myocardial infarction and angina.

Women with polycystic ovary syndrome have a higher incidence and age-specific prevalence of cardiovascular diseases and diabetes, researchers found.

In a restrospective cohort, polycystic ovary syndrome was associated with higher incidence of myocardial infarction (incidence rate of 0.8 per 1,000 person-years), and angina (1 per 1,000 person-years), according to Hamidreza Mani, PhD, of Leicester General Hospital in England, and colleagues.

Compared with rates of myocardial infarction (MI) and angina among local women without polycystic ovary syndrome, the odds of women with polycystic ovary syndrome developing one of those two conditions ranged from of two-and-a-half-fold (OR 2.6, 95% CI 1.0 to 6.3) to nearly 13-fold (OR 12.9, 95% CI 3.4 to 48.6), depending on age and which condition is specified, they wrote online in the journal Clinical Endocrinology.

Women with polycystic ovary syndrome also had a higher incidence of diabetes (3.6 per 1,000 person-years), they noted.

“These findings stress the importance of identifying such cardiovascular and diabetes risk factors in women presenting with polycystic ovary syndrome,” the authors wrote, adding that early identification can help introduce early intervention to alter patients’ lifestyles and reduce cardiovascular risks.

The authors noted that prior research has shown an increased risk of cardiovascular diseases among women with polycystic ovary syndrome, including insulin resistance, obesity, and diabetes.

To explore the issue further, the researchers looked at incidence and prevalence of cardiovascular events among a population of 2,301 women with polycystic ovary syndrome at a specialty clinic in England, and compared those rates against those of the general female population in the area surrounding that clinic.

Inclusion criteria included a clinical visit between October 1988 and November 2009, being at least 16 years old at baseline, and clinical diagnosis of polycystic ovary syndrome. Data were extracted on patients’ weight, body mass index, composite cardiovascular outcome, along with incidence of MI, angina, heart failure, stroke, and cardiovascular mortality, which all contributed to composite cardiovascular outcome.

Incidence rates were based on the number of new cases divided by the total person-years at risk for a given condition. Participants were followed up with until they presented with a cardiovascular condition, died, or left the area; or until the study period concluded.

Outcomes were stratified by age ranges, including 15 to 44, 45 to 54, 55 to 64, and 65 and older. Odds ratios were calculated through measuring cardiovascular outcomes of the study population against the local female population that did not present with polycystic ovary syndrome.

Participants were a mean 29.6 years old at baseline and, among a subsample of 1,810 participants with body weight calculated, 24.7% were normal weight, 23.8% were overweight, and 51.5% were obese. Those whose weight was not calculated had significantly lower systolic blood pressure (mean 114 mmHg versus 130.6 mmHg, P<0.01), were more likely to be of South Asian descent (31.4% versus 28.9%, P=0.02), were less likely to smoke (5.9% versus 15.6%, P<0.01), and had a lower history of hypertension (3.1% versus 11%,P<0.01).

At the end of the cohort, cardiovascular symptom prevalence included 6% of patients with diabetes, 0.7% who had experienced MI, 1% who had experienced angina, and 0.2% who had experienced heart failure.

After a logistic regression and adjustment, risk of diabetes was associated with history of hypertension, older age, overweight or obese status, and South Asian ethnicity, while androgen excess was associated with a lower risk.

Cardiovascular event risk was associated with history of hypertension, older age, and smoking, and anovulation was associated with a lower risk, each after a logistic regression and adjustment.

Women with polycystic ovary syndrome “demonstrated an increased age-specific prevalence of diabetes and cardiovascular morbidity compared to the local and national female population,” as well as “an excess of other well-established cardiovascular risk factors compared to those without events, including hypertension and smoking,” they concluded.

The authors noted that the study was limited by a lack of a matched control group, missing database data, and lack of comprehensive single-patient data.