Cardiovascular disease in women with polycystic ovary syndrome at long‐term follow‐up: a retrospective cohort study
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OBJECTIVE: Polycystic ovary syndrome (PCOS) is associated with higher prevalence of cardiovascular risk factors but the relative prevalence of cardiovascular disease in women with PCOS has not previously been reported. We have compared cardiovascular mortality and morbidity in middle‐aged women previously diagnosed with PCOS and age‐matched control women. DESIGN: A retrospective cohort study of women diagnosed with PCOS in the United Kingdom before 1979. PATIENTS: Seventy cohort members died before 31 March 1999. Morbidity data were collected from 319 women with PCOS and 1060 age‐matched control women. Sixty‐one women with PCOS and 63 control women attended a clinical examination. MEASUREMENTS: Data were collected from death certificates, general practitioners' records and questionnaires with measurement of cardiovascular risk factors in a subsample of questionnaire respondents. RESULTS: All‐cause and cardiovascular mortality in the cohort were similar to women in the general population (standardized mortality ratios (95% CI): 93 (72–117) and 78 (45–124), respectively). Women with PCOS had higher levels of several cardiovascular risk factors: diabetes ( P = 0.002) hypertension ( P = 0.04), hypercholesterolaemia ( P < 0.001), hypertriglyceridaemia ( P = 0.02) and increased waist:hip ratio ( P = 0.004). After adjustment for BMI, odds ratios (OR) were 2.2 (0.9–5.2) for diabetes, 1.4 (0.9–2.0) for hypertension and 3.2 (1.7–6.0) for hypercholesterolaemia. A history of coronary heart disease (CHD) was not significantly more common in women with PCOS (crude OR (95%CI) 1.5 (0.7–2.9)) but the crude OR for cerebrovascular disease was 2.8 (1.1–7.1). CONCLUSION: At long‐term follow‐up, a history of nonfatal cerebrovascular disease and cardiovascular risk factors including diabetes are more prevalent among women with polycystic ovary syndrome. Morbidity and mortality from of coronary heart disease among women with polycystic ovary syndrome is not as high as previously predicted. This finding challenges our understanding of the aetiology of coronary heart disease in women.
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In PCOS, other novel CVD risk factors, premature cardiovascular dysfunction and subclinical CVD have been noted and are related to IR and obesity.
“In PCOS, other novel CVD risk factors, premature cardiovascular dysfunction and subclinical CVD 29,30,83 have been noted and are related to IR and obesity. 84-89”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [89]
Poor-quality long-term PCOS studies have not shown increased CVD.
“however, poor-quality long-term PCOS studies have not shown increased CVD. 89,92”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [89]
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Barber, T. M., & Franks, S. (2013) · Expert Review of Endocrinology & Metabolism · doi:10.1586/17446651.2013.827373 · Cited by 15 · see citing works
Wang, Y., Xiang, T., Xia, X., Zhang, H., Geng, S., Yang, G., Qiu, S., He, Y., Liu, R., Li, L., et al. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1010714 · Cited by 5 · see citing works
- Authors
- Wild, S., Pierpoint, T., McKeigue, P., & Jacobs, H.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- University College London (GB)
- Corresponding author
- Wild, Sarah
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2000-05-19
- Volume
- 52
- Issue
- 5
- Pages
- 595-600
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2152097518
- Cited by
- 970
- References
- 21
- Citations by year
- 2026: 6 · 2025: 15 · 2024: 13 · 2023: 21 · 2022: 26 · 2021: 24 · 2020: 23 · 2019: 23 · 2018: 261 · 2017: 50 · 2016: 26 · 2015: 45 · 2014: 29 · 2013: 25 · 2012: 26
- FWCI
- 27.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- polycystic ovary syndrome, cardiovascular disease, cardiovascular mortality, cardiovascular risk factors, diabetes mellitus, hypertension, hypercholesterolemia, hypertriglyceridemia, waist-to-hip ratio, cerebrovascular disease, coronary artery disease, middle-aged women, long-term follow-up, standardized mortality ratio, hyperandrogenism, insulin resistance, obesity, hyperinsulinemia
- MeSH terms
- Aged, Body Constitution, Cerebrovascular Disorders, Coronary Disease, Female, Follow-Up Studies, Humans, Hypercholesterolemia, Hypertension, Middle Aged, Morbidity, Polycystic Ovary Syndrome, Retrospective Studies, Risk Factors, Hypertriglyceridemia, Cohort Studies, Odds Ratio, Diabetes Complications
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