Assessment of Cardiovascular Risk and Prevention of Cardiovascular Disease in Women with the Polycystic Ovary Syndrome: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society
Abstract
OBJECTIVE: Women with polycystic ovary syndrome (PCOS) often have cardiovascular disease (CVD) risk factors. The Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society created a panel to provide evidence-based reviews of studies assessing PCOS-CVD risk relationships and to develop guidelines for preventing CVD. PARTICIPANTS: An expert panel in PCOS and CVD reviewed literature and presented recommendations. EVIDENCE: Only studies comparing PCOS with control patients were included. All electronic databases were searched; reviews included individual studies/databases, systematic reviews, abstracts, and expert data. Articles were excluded if other hyperandrogenic disorders were not excluded, PCOS diagnosis was unclear, controls were not described, or methodology precluded evaluation. Inclusion/exclusion criteria were confirmed by at least two reviewers and arbitrated by a third. CONSENSUS PROCESS: Systematic reviews of CVD risk factors were compiled and submitted for approval to the AE-PCOS Society Board. CONCLUSIONS: Women with PCOS with obesity, cigarette smoking, dyslipidemia, hypertension, impaired glucose tolerance, and subclinical vascular disease are at risk, whereas those with metabolic syndrome and/or type 2 diabetes mellitus are at high risk for CVD. Body mass index, waist circumference, serum lipid/glucose, and blood pressure determinations are recommended for all women with PCOS, as is oral glucose tolerance testing in those with obesity, advanced age, personal history of gestational diabetes, or family history of type 2 diabetes mellitus. Mood disorder assessment is suggested in all PCOS patients. Lifestyle management is recommended for primary CVD prevention, targeting low-density and non-high-density lipoprotein cholesterol and adding insulin-sensitizing and other drugs if dyslipidemia or other risk factors persist.
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We did not identify high-quality PCOS-specific evidence to answer the question, hence a clinical consensus recommendation was made based on clinical expertise, an international position statement on CVD risk assessment in PCOS and on national guidelines on absolute CVD risk assessment, management of obesity, lipids and hypertension for the general population.
“We did not identify high-quality PCOS-specific evidence to answer the question, hence a clinical consensus recommendation was made based on clinical expertise, an international position statement on CVD risk assessment in PCOS 78 and on national guidelines on absolute CVD risk assessment, 46 management of obesity, 54 lipids 77,79 and hypertension 80 for the general population.”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [78]
Previous studies have noted that fasting blood glucose level alone appears to lack sensitivity in screening for prediabetes or DM2 in PCOS, with national and international groups recommending screening all women with PCOS with an OGTT.
“Previous studies have noted that fasting blood glucose level alone appears to lack sensitivity in screening for prediabetes or DM2 in PCOS, with national and international groups recommending screening all women with PCOS with an OGTT. 78,107”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [78]
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Self-citationAHA/ACCF 2009 Performance Measures for Primary Prevention of Cardiovascular Disease in Adults
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“A 2-h post 75-g oral glucose challenge be performed in PCOS women with a BMI greater than 30 kg/m2, or alternatively in lean PCOS women with advanced age ( 40 yr), personal history of gestational diabetes, or family history of T2DM (44, 93).”
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Self-citationEndocrine and Metabolic Effects of Rosiglitazone in Non-obese Women with Polycystic Ovary Disease
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Self-citationLipid Triad or Atherogenic Lipoprotein Phenotype: A Role in Cardiovascular Prevention?
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Self-citationCriteria, Prevalence, and Phenotypes of Polycystic Ovary Syndrome
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Self-citationLipid Levels in Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis
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Self-citationVisceral Adiposity Index: An Indicator of Adipose Tissue Dysfunction
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Self-citationDeconstructing a Syndrome: Genomic Insights Into PCOS Causal Mechanisms and Classification
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Self-citation
- Authors
- Wild, R. A., Carmina, E., Diamanti-Kandarakis, E., Dokras, A., Escobar-Morreale, H. F., Futterweit, W., Lobo, R., Norman, R. J., Talbott, E., & Dumesic, D. A.
- Affiliations
- OU Health (US)
- University of Palermo (IT)
- University of Athens Medical School (E.D.-K.), 11527 Athens, Greece
- University of Pennsylvania (US)
- Hospital Ramon y Cajal (H.F.E.-M.), 28034 Madrid, Spain
- Icahn School of Medicine at Mount Sinai (US)
- Columbia University (R.L.), New York, New York 10027
- The University of Adelaide (AU)
- University of Pittsburgh (US)
- University of Wisconsin–Madison (US)
- Corresponding author
- Carmina, Enrico
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2010-05-01
- Volume
- 95
- Issue
- 5
- Pages
- 2038-2049
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2105749473
- Semantic Scholar
- 5556ce96457d5a9ef1f00894a9f61047e5c6afb4
- Cited by
- 1,010
- References
- 146
- Citations by year
- 2026: 34 · 2025: 47 · 2024: 45 · 2023: 62 · 2022: 77 · 2021: 52 · 2020: 56 · 2019: 73 · 2018: 61 · 2017: 58 · 2016: 62 · 2015: 89 · 2014: 85 · 2013: 69 · 2012: 62
- FWCI
- 79.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
- 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 risk, cardiovascular disease prevention, hyperandrogenism, obesity, dyslipidemia, hypertension, impaired glucose tolerance, metabolic syndrome, type 2 diabetes, subclinical vascular disease, body mass index, waist circumference, oral glucose tolerance test, mood disorders, lifestyle management, insulin-sensitizing drugs, cardiovascular risk assessment
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Humans, Polycystic Ovary Syndrome, Risk Factors, Body Mass Index, Glucose Intolerance, Risk Assessment, Waist-Hip Ratio, Atherosclerosis
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