LONG-TERM CARDIOVASCULAR RISK IN WOMEN WITH PCOS

Abstract

Objective:
Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age and is known to be associated with a variety of metabolic and reproductive complications. Recent studies suggest that women with PCOS may also be at an increased risk of long-term cardiovascular diseases (CVD) due to underlying metabolic disturbances such as insulin resistance, obesity, and dyslipidemia. The primary objective of this retrospective cohort study was to evaluate the long-term cardiovascular risk factors and outcomes in women diagnosed with PCOS, specifically examining the incidence of hypertension, dyslipidemia, and other cardiovascular events over a period of 10 years.

Methods:
This study was conducted at a tertiary hospital in Lahore, Pakistan, involving a cohort of 200 women diagnosed with PCOS between 2005 and 2015. A control group of 200 age- and sex-matched women without PCOS was also included for comparison. Clinical data, including blood pressure, lipid profiles, and body mass index (BMI), were collected at baseline and every two years for a total of 10 years. Additional diagnostic tests for insulin resistance, including the Homeostasis Model Assessment (HOMA-IR), were performed. Cardiovascular events such as stroke, myocardial infarction, and hospitalization for angina were also tracked during the follow-up period. Statistical analysis was performed to compare the incidence of cardiovascular risk factors between the PCOS and control groups.

Results:
The study revealed that women with PCOS had a significantly higher incidence of hypertension (42%) and dyslipidemia (58%) compared to the control group (hypertension: 28%, dyslipidemia: 38%). Additionally, 22% of women with PCOS developed metabolic syndrome over the 10-year follow-up period, compared to only 12% of women in the control group. Insulin resistance was found to be a major contributor to the increased cardiovascular risk in the PCOS group, with women exhibiting higher levels of HOMA-IR at baseline and throughout the study period. Cardiovascular events, including myocardial infarction and stroke, were more frequent in the PCOS group, with a 15% higher incidence compared to the control group.

Conclusion:
The findings of this study suggest that women with PCOS are at a significantly higher risk for developing hypertension, dyslipidemia, and metabolic syndrome, which in turn contribute to an elevated long-term risk of cardiovascular events. The study emphasizes the importance of early and regular cardiovascular screening in women with PCOS, particularly those with additional metabolic risk factors such as obesity and insulin resistance. Early intervention and lifestyle modifications could play a crucial role in reducing the cardiovascular burden in this population. This research provides valuable insights into the long-term health implications of PCOS, especially in the context of a developing nation like Pakistan.