Self-Reported Polycystic Ovary Syndrome Is Associated With Hypertension: A Northern Finland Birth Cohort 1966 Study

Abstract

Context Polycystic ovary syndrome (PCOS) is associated with many traditional cardiovascular disease risk factors, but it is unclear whether PCOS is an independent risk factor for hypertension. Objective To investigate in a population-based setup whether PCOS associates with the risk of hypertension independently of body mass index (BMI) and with cardiovascular manifestations. Design Cross-sectional assessments in the Northern Finland Birth Cohort 1966 at ages 31 and 46 years. Setting General community. Participants Women who reported both oligo/amenorrhea and hirsutism at age 31 years and/or a diagnosis of PCOS by age 46 years [self-reported PCOS (srPCOS), n = 279] and women without PCOS symptoms or diagnosis (n = 1577). Intervention None. Main Outcome Measures Blood pressure (BP), BMI, and cardiovascular manifestations. Results Use of antihypertensive medication was significantly more common in women with srPCOS. At age 31 years, women with srPCOS had significantly higher systolic BP (SBP) and diastolic BP (DBP) than control women (SBP: normal weight: 119.9 ± 13.2 vs 116.9 ± 11.4 mm Hg, P = 0.017; overweight/obese: 126.1 ± 14.3 vs 123.0 ± 11.9 mm Hg, P = 0.031; and DBP: normal weight: 75.5 ± 10.0 vs 72.4 ± 9.6 mm Hg, P = 0.003; overweight/obese: 80.7 ± 11.8 vs 78.0 ± 10.6 mm Hg, P = 0.031). At age 46 years, srPCOS was significantly associated with hypertension (adjusted odds ratio = 1.56; 95% CI, 1.14 to 2.13) independently of BMI and with higher cardiovascular morbidity (6.8% vs 3.4%, P = 0.011). Hypertensive srPCOS displayed consistent, unfavorable changes in cardiac structure and function compared with controls. Conclusion Women with srPCOS displayed higher BP compared with controls already at early age and srPCOS was associated with hypertension independently of overweight/obesity. srPCOS was associated with increased cardiovascular morbidity in premenopausal women, suggesting that cardiovascular disease risk factors should be screened and efficiently managed early enough in women with PCOS.

Vitamin D Levels in Women with Polycystic Ovary Syndrome: A Population-Based Study

“…Women with PCOS did show the accumulation of several metabolic risk factors, namely, high BMI, HOMA-IR, and hs-CRP. Moreover, studies from this cohort report a higher rate of type 2 diabetes (T2D), hypertension, and dyslipidemia in affected women [27,41,42]. Our results revealed that, despite these metabolic derangements, women with PCOS have an adequate vitamin D status compared with the controls.…”

“…The limitations of our study include the use of self-reported symptoms and diagnosis of PCOS. However, other studies using the present cohort have validated that self-reported symptoms and PCOS diagnosis are reliable in successfully identifying women with PCOS [24,25,26,27,42]. Because hormonal contraceptives can be used to treat PCOS symptoms and those using such regiments were excluded from the study, the true number of PCOS participants may have been underestimated [66].…”

Effect of polycystic ovary syndrome on cardiac autonomic function at a late fertile age: a prospective Northern Finland Birth Cohort 1966 study

“…Waist circumference was measured at the level midway between the lowest rib margin and the iliac crest. Brachial SBP and DBP were measured three times with 1 min interval after 15 min rest by an automated, oscillometric BP device with an appropriately sized cuff (Omron Digital Automatic Blood Pressure Monitor Model M10-IT; Omron, Kyoto, Japan), and SBP and DBP averages were calculated 18. The level of glucose metabolism was classified according to WHO standards,19 based on a 2-hour oral glucose tolerance test (performed at age 46) and a previously established diagnosis of type 2 diabetes 20…”

Blood pressure and hypertension during pregnancy in women with polycystic ovary syndrome: Odense Child Cohort

“…In the adjusted model, we decided a priori to include the following covariates: Educational level (high school or less; high school +1‐4 years; high school +>4 years), 33 ethnicity (western; non‐western) 33 and smoking (yes; no) 34 . Baseline BP (continuous) 6‐8 and number of visits (ie every time a BP was measured and registered) were chosen as additional confounders. Baseline BP was chosen as a confounder to take any baseline imbalance between the groups into account, according to Vickers and Altman 35 …”

“…The risk of hypertension (HT) in women with PCOS could be associated with body mass index (BMI) 4,5 . Two recent Scandinavian prospective studies confirmed higher systolic and diastolic blood pressure (BP) in premenopausal women with PCOS 6,7 . In a Danish register‐based study, young women with PCOS had an odds ratio (OR) of 1.7 for development of cardiovascular disease including HT 8 …”