Meri-Maija E Ollila1, Kari Kaikkonen2, Marjo-Riitta Järvelin3,4,5,6,7, Heikki V Huikuri8, Juha S Tapanainen1,9, Stephen Franks10, Terhi T Piltonen1, Laure Morin-Papunen1. 1. Department of Obstetrics and Gynecology, University of Oulu and Oulu University Hospital, Medical Research Center, PEDEGO Research Unit, Oulu, Finland. 2. Division of Cardiology, Department of Clinical Medicine, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland. 3. MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom. 4. Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland. 5. Biocenter Oulu, University of Oulu, Oulu, Finland. 6. Unit of Primary Health Care, Oulu University Hospital, OYS, Oulu, Finland. 7. Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom. 8. Research Unit of Internal Medicine, Medical Research Center, University Hospital of Oulu and University of Oulu, Oulu, Finland. 9. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 10. Institute of Reproductive and Developmental Biology, Imperial College London, London, United Kingdom.
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.
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.
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