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Cited by 466Ovarian function and disordersDiabetes, Cardiovascular Risks, and LipoproteinsHormonal and reproductive studies

Polycystic ovary syndrome and cardiovascular disease: a premature association?

Legro, Richard S.·2003·Endocrine Reviews
DOI 10.1210/er.2003-0004
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Abstract

Women with polycystic ovary syndrome (PCOS) are often assumed, a priori, to be at increased risk for cardiovascular disease (CVD), given the high prevalence of the metabolic syndrome X among them. There is, however, no single definition of PCOS, and for that reason a comparison of studies that have analyzed its association with CVD is compromised from the start. Long-term studies of well characterized women with PCOS are lacking, and the link to primary cardiovascular events such as stroke or myocardial infarction remains more speculative than substantive. Epidemiological studies that have focused on isolated signs and stigmata of PCOS, such as polycystic ovaries, hyperandrogenism, or chronic anovulation, have found mixed results. There are studies that suggest a slight increase in cardiovascular events in women with polycystic ovaries, with perhaps stronger evidence between an increased risk of cardiovascular events in women with menstrual irregularity. However, there is little evidence for an association between hyperandrogenism per se and cardiovascular events. Furthermore, there are less data to substantiate an increased risk of events in women with PCOS identified on the basis of a combination of signs and symptoms, such as hyperandrogenic chronic anovulation. The existing data suggest that PCOS may adversely affect or accelerate the development of an adverse cardiovascular risk profile, and even of subclinical signs of atherosclerosis, but it does not appear to lower the age of clinical presentation to a premenopausal age group. Future studies to identify the risk of cardiovascular events in women with PCOS will benefit from clear and extensive phenotyping of PCOS abnormalities at baseline, from a prospective design, from larger sample sizes, and from longer follow-up.

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  • The same is not necessarily true of exogenous or supraphysiological doses of estrogens, as demonstrated by conflicting reports about the effects of hormone replacement therapy on the risk of hypertension and incident CVD.

    “However, the same is not necessarily true of exogenous or supraphysiological doses of estrogens, as demonstrated by conflicting reports about the effects of hormone replacement therapy on the risk of hypertension and incident CVD (39).”

    From Cardiovascular Risk Following Fertility Therapy (2017) · cites this paper as [39]

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Authors
Legro, R. S.
Affiliations
Pennsylvania State University (US)
Corresponding author
Legro, Richard S.
ORCID
Legro, Richard S.
Venue
Endocrine Reviews
Publisher
The Endocrine Society
Published
2003-06-01
Volume
24
Issue
3
Pages
302-312
ISSN
  • 0163-769X (ISSN-L)
  • 1945-7189
DOI
10.1210/er.2003-0004
OpenAlex
W2166237661
Cited by
466
References
118
Citations by year
2026: 2 · 2025: 7 · 2024: 14 · 2023: 6 · 2022: 12 · 2021: 11 · 2020: 17 · 2019: 14 · 2018: 12 · 2017: 20 · 2016: 17 · 2015: 11 · 2014: 19 · 2013: 22 · 2012: 22
FWCI
5.65
Type
journal article
Language
en
Open access
closed
Locations
  • Endocrine Reviews (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Deutsches Krebsforschungszentrum
  • National Center for Research Resources (M01 RR10732, M01RR010732)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (U54-HD34449, U10-HD38992, K24 HD01476, U54HD034449, K24HD001476, U10HD038992)
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 › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
polycystic ovary syndrome, cardiovascular disease, cardiovascular risk, hyperandrogenism, chronic anovulation, metabolic syndrome X, menstrual irregularity, stroke, myocardial infarction, atherosclerosis, premenopausal women
MeSH terms
Anovulation, Cardiovascular Diseases, Chronic Disease, Female, Humans, Polycystic Ovary Syndrome, Risk Factors, Hyperandrogenism

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