What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Polycystic ovary syndrome. Intervention: Polycystic ovary syndrome vs. Control population (without PCOS). Primary outcome: Hypertension (SBP ≥ 140 mmHg and DBP ≥ 90 mmHg or current use of anti-hypertensive medicine) (RR 1.60, 95% CI 1.36-1.87).

What does this research mean for the field?

Polycystic ovary syndrome is associated with a 1.60-fold increased relative risk of hypertension compared to controls, but this increased risk is observed exclusively in reproductive-age women and not in menopausal or aging patients. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 17, 2020Open Access

Risk of hypertension in women with polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression

Resultado clave

Polycystic ovary syndrome was associated with a 1.60-fold increased relative risk of hypertension compared to controls, with the increased risk observed only in reproductive-age women (RR 1.70).

Diseño del estudio

Tipo

Meta-Analysis

PICO estructurado

Does polycystic ovary syndrome increase the risk of hypertension in reproductive age and menopausal/aging women?

Población

Women with polycystic ovary syndrome (PCOS), including reproductive age and menopausal/aging groups, pooled from 30 observational studies.

Intervención

Polycystic ovary syndrome (PCOS) as an exposure

Comparador

Control population of women without PCOS of similar ages

Resultado

Pooled prevalence and relative risk of hypertension (defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or current use of anti-hypertensive medicine)

PCOS is associated with a significantly increased risk of hypertension in reproductive-age women, but this increased risk does not appear to persist after menopause.

Resultado numérico

Estimación del efecto: RR 1.60 (95% CI 1.36-1.87)

Limitaciones

Small number of studies assessing hypertension in postmenopausal PCOS women
Some studies did not report a crude relative risk or the exact number of hypertension cases
Most studies did not report details of the blood pressure measurement methods and standard conditions
Possible influence of body weight and obesity on reported results could not be assessed due to paucity of data

Resumen

BACKGROUND: A limited number of publications have assessed the prevalence of hypertension (HTN) in polycystic ovary syndrome (PCOS) patients with inconclusive results. Since in general populations the occurrence of hypertension is related to age per se, we investigated the prevalence (P) / relative risk (RR) of HTN in pooled patients with PCOS, vs control population among reproductive age women with PCOS, compared to menopause/aging patients. METHODS: PubMed, Scopus, ScienceDirect, web of science, and Google scholar were systematically searched for retrieving observational studies published from inception to April 2019 investigating the HTN in patients with PCOS. The primary outcome of interest was pooled P and RR of HTN in reproductive and menopausal/aging women with PCOS compared to control population. RESULTS: The pooled prevalence of HTN in reproductive and menopausal/aging women with PCOS was higher than in the control population (Pooled P: 0.15, 95% CI: 0.12-0.18 vs. Pooled P: 0.09, 95% CI: 0.08-0.10) and (Pooled P: 0.49, 95% CI: 0.28-0.70 vs. Pooled P: 0.40, 95% CI: 0.22-0.57), respectively. Compared to the control population, pooled relative risk (RR) of HTN patients was increased only in reproductive age PCOS (1.70-fold, 95% CI: 1.43-2.07) but not in menopausal/aging patients who had PCOS during their reproductive years. The same results were obtained for subgroups of population-based studies. Meta-regression analysis of population-based studies showed that the RR of HTN in reproductive age PCOS patients was 1.76-fold than menopausal/aging PCOS patients (P = 0.262). CONCLUSION: This meta-analysis confirms a greater risk of HTN in PCOS patients but demonstrates that this risk is increased only in reproductive age women with PCOS, indicating that after menopause, having a history of PCOS may not be as an important predisposing factor for developing HTN.

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