PCOS Forum

Research in Polycystic Ovary Syndrome Today and Tomorrow

Renato Pasquali; Elisabet Stener-Victorin; Bulent O. Yildiz; Antoni J. Duleba; Kathleen Hoeger; Helen Mason; Roy Homburg; Theresa Hickey; Steve Franks; Juha S. Tapanainen; Adam Balen; David H. Abbott; Evanthia Diamanti-Kandarakis; Richard S. Legro

Disclosures

Clin Endocrinol. 2011;74(4):424-433. 

In This Article

Long-term Outcomes in PCOS: Vascular Disease

The higher sex-specific coronary mortality observed in women compared with men, combined with a greater proportion of women in the population, has resulted in relatively more women dying of cardiovascular disease (CVD) each year than men.[72]

Endogenous sex hormones including oestrogen are hypothesized as the primary reason for the lower incidence of CVD among normal ovulatory premenopausal women compared with age-matched men and the subsequent age-related rise in women postmenopausally.[73] Moreover, there is a clear evidence from a large number of clinical studies that women with PCOS have a higher prevalence of classical and nonclassical risk factors, which are strictly related to the presence of insulin resistance, excess body fat and low-grade inflammation, other than PCOS status per se.[74] However, despite risk factor clustering, studies published to date have failed to demonstrate a uniform association between PCOS and CV disease.[75,76] An apparent lack of association between PCOS and CVD may be attributed to inadequate PCOS characterization, inadequate CVD measurement, insufficient duration of follow-up or a true lack of association. A recent study tested the hypothesis that women with clinical features of PCOS more often had angiographic coronary artery disease and CVD events in a carefully characterized group of postmenopausal women in USA.[77] This study confirmed that clinical features of PCOS were associated with more angiographic coronary heart disease and worsening cardiovascular event-free survival, which suggests that the identification of postmenopausal women with clinical features of PCOS may provide an opportunity for risk factor intervention for the prevention of CAD and CVD events. However, this still require much more intensive research and, possibly, longitudinal prospective studies.

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