Journal
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 104, Issue 4, Pages 1221-1231Publisher
ENDOCRINE SOC
DOI: 10.1210/jc.2018-00570
Keywords
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Funding
- Finnish Medical Foundation
- North Ostrobothnia Regional Fund
- Academy of Finland [315921, 104781, 120315, 129269, 1114194, 24300796, 295760]
- Center of Excellence in Complex Disease Genetics and SALVE
- Sigrid Juselius Foundation
- University of Oulu [75617]
- Medical Research Center Oulu
- National Institute for Health Research (UK)
- Genesis Research Trust (UK)
- NHLBI through the STAMPEED program [5R01HL087679-02, 1RL1MH083268-01]
- ENGAGE project from the European Commission
- MRC, Centenary Early Career Award
- NIH/NIMH [5R01MH63706: 02]
- University Hospital Oulu [75617]
- European Commission [HEALTH-F4-2007-201413, EU FP7 EurHEALTHAgeing-277849]
- Academy of Finland (AKA) [295760, 295760] Funding Source: Academy of Finland (AKA)
- MRC [G0802782] Funding Source: UKRI
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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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