Young women with polycystic ovary syndrome have raised risk of heart disease

Sophia Antipolis, 3 August 2020: Women in their 30s and 40s with a common condition affecting how the ovaries work are more likely to get heart disease. That's the finding of a study published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).1

"Polycystic ovary syndrome isn't a life sentence - there are many ways to stay heart healthy," said study author Dr. Clare Oliver-Williams of the University of Cambridge, UK. "Small changes add up, like eating more fruits and vegetables and doing more exercise."

It is estimated that 6-20% of women of reproductive age have polycystic ovary syndrome (PCOS).2 Features of the condition include multiple cysts (fluid-filled sacs) on the ovaries, irregular periods, excess body hair or hair loss from the head due to high levels of male hormones, and difficulty becoming pregnant.

Women with PCOS are more likely to be overweight or obese, have diabetes, and have high blood pressure - all risk factors for heart disease and stroke.

This study examined whether this risky profile translates into a greater likelihood of developing cardiovascular disease - and, for the first time, whether that persists across the lifespan. Dr. Oliver-Williams explained: "Some PCOS symptoms are only present during the reproductive years, so it's possible that the raised chance of heart disease might disappear later in life."

The study included 60,574 women receiving treatment to help them get pregnant, such as in vitro fertilisation (IVF), from 1994 to 2015. Of those, 6,149 (10.2%) had PCOS. The researchers used medical records to follow the women for nine years. During that period, 2,925 (4.8%) women developed cardiovascular disease.

Overall, women with PCOS were at 19% higher risk of developing cardiovascular disease than women who did not have PCOS.

When divided into age groups, women with PCOS aged 50 and over did not have a higher risk of developing cardiovascular risk compared to their peers without PCOS.

Women in their 30s and 40s with PCOS were at greater risk of cardiovascular disease compared to those without PCOS. The evidence in those under 30 was less clear; this is likely because there were insufficient women of that age in the dataset to identify the risk.

Dr. Oliver-Williams said: "Heart health appears to be a particular problem for young women with PCOS. This may be because they are more likely to be overweight and have high blood pressure and diabetes compared to their peers. Previous studies have suggested that these differences diminish with age. In other words, as women without PCOS get older, they increasingly become overweight and develop high blood pressure and diabetes. In a negative sense, they catch up to their peers with PCOS."

She encouraged young women with PCOS to stay positive: "PCOS can be a distressing condition. Not just because it can affect fertility. The physical effects can cause anxiety and depression. There's so much pressure on young women to achieve what we're told is the physical ideal. It takes age and time to embrace yourself and getting support from others is a vital step, so reach out if you need it."

"Knowledge is power and being aware of the heart risks means women with PCOS can do something about it," said Dr. Oliver-Williams. "Women with PCOS have been dealt a tough hand but this is about how these women play their cards. There are fantastic PCOS support groups where they can find out what has helped others with PCOS lose weight, get more exercise, and have a healthier diet."

She noted that the study only included Scandinavian women taking fertility treatment and caution is needed when extending the findings to other groups.

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Acknowledgements: The study was conducted in collaboration with researchers at the University of Copenhagen and Copenhagen University Hospital.

Funding: This work was funded by the British Heart Foundation (RE/13/6/30180), a doctoral research grant to DV from the Faculty of Health and Medical Sciences, University of Copenhagen (Copenhagen, Denmark), a research fellowship to COW from Homerton College, University of Cambridge, a travel fellowship to COW from the European Society of Human Reproduction and Embryology and ReproUnion, and this article is part of the ReproUnion collaborative study, co-financed by the European Union, Intereg V Oresund-Kattegat-Skagerrak.

Disclosures: None.

1Oliver-Williams C, Vassard D, Pinborg A, Schmidt L. Risk of cardiovascular disease for women with polycystic ovary syndrome: results from a national Danish registry cohort study. Eur J Prev Cardiol. 2020. doi:10.1177/2047487320939674.

2Jayasena CN, Franks S. The Management of Patients With Polycystic Ovary Syndrome. Nat Rev Endocrinol. 2014;10:624-636.

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

The European Journal of Preventive Cardiology is the world's leading preventive cardiology journal, playing a pivotal role in reducing the global burden of cardiovascular disease.

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