Exploring relationships between training level and arterial stiffness amongst females with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) affects ~10% of females and is associated with increased risk for virtually all cardiovascular diseases. Arterial stiffness has utility as an early marker of cardiovascular risk, as elevated arterial stiffness is a precursor to atherosclerosis, a potent cardiovascular risk factor. Arterial stiffness is quantified as pulse wave velocity (PWV) via applanation tonometry and is commonly elevated in females with PCOS. Habitual exercise training has been recommended to reduce cardiovascular risk in females with PCOS; however, training-induced mitigation of cardiovascular risk has been inconsistent in PCOS, suggesting that exercise training may not be as effective in mitigating cardiovascular disease risk PCOS compared to the general population. Nevertheless, it is possible that early markers of cardiovascular risk such as PWV may demonstrate a marginal benefit of habitual exercise training in PCOS. Thus, we conducted a cross-sectional observational study on the effects of habitual, high-volume exercise on PWV. We recruited trained (>5 hours of moderate to vigorous physical activity weekly for ≥ 1yr) and untrained (< 1 hour of moderate to vigorous physical activity weekly for ≥ 1yr) females with and without PCOS (CTRL). We hypothesized that (a) PWV would be higher in PCOS than CTRL, and (b) the PWV-lowering effects of training would be more pronounced in CTRL than PCOS, resulting in (c) the effect of PCOS differing between trained and untrained groups (i.e. PWV: untrained PCOS > untrained CTRL = trained PCOS > trained CTRL). Central PWV was assessed via applanation tonometry; blood pressure was assessed via beat-by-beat finger photoplethysmography (calibrated to manual sphygomomanometry-derived values). A 1-way ANOVA assessed age and body mass index (BMI) across groups; neither were different between trained PCOS (n=6, 24±6 yrs, 22.7±3.6 kg/m 2 ), trained CTRL (n=6, 23±5 yrs, 22.3±2.5 kg/m 2 ), untrained PCOS (n=5, 24±6 yrs, 25.1±5.9 kg/m 2 ), or untrained CTRL (n=6, 26±6 yrs, 22.9±4.4 kg/m 2 ; p=0.77 & p=0.71; respectively). A two-way ANOVA indicated no effect of training (p=0.22) or PCOS (p=0.99) on PWV. However, a training x PCOS interaction (p=0.02) – which persisted when including mean arterial pressure as a covariate (p=0.02) – revealed that PWV was higher in untrained CTRL than trained CTRL (6.75±0.77 vs. 5.49±0.82m/s; Bonferroni-corrected pairwise comparison: p=0.01), but did not differ between trained and untrained PCOS (6.30±0.78 vs. 5.95±0.86m/s; p=0.51), or between trained PCOS and untrained CTRL (6.30±0.78 vs 6.75±0.77; p=0.26). These preliminary cross-sectional findings suggest that habitual exercise training favors lower arterial stiffness in CTRL, but not in females with PCOS. Longitudinal research studies investigating the effects of exercise training on arterial stiffness are needed to confirm and expand upon these findings. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.