Autonomic dysfunction in polycystic ovary syndrome may drive cardiovascular risk, with evidence suggesting increased sympathetic activity and reduced vagal control of heart rate.
Autonomic dysfunction, characterized by increased sympathetic activity and reduced vagal control, may be a key mechanism driving excess cardiovascular risk in women with PCOS.
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting premenopausal females. Alongside the endocrine, reproductive and psychological consequences of the condition, PCOS has now been linked to increased risk of cardiovascular and metabolic disease e.g., insulin resistance. The mechanisms behind this excess risk are not fully understood and multiple characteristics of PCOS (e.g., hyperandrogenism, obesity and vascular dysfunction) likely contribute to individual risk. Autonomic dysfunction may also drive cardiovascular risk in PCOS, via its effects on both blood pressure control and the modulation of sex hormone release at the ovaries. Whilst current studies are limited by moderate sample sizes and one-off measurements, evidence broadly suggests that sympathetic activity may be increased, and vagal control of heart rate may be reduced in PCOS. In this review, we examine the potential mechanisms by which autonomic dysfunction may occur in PCOS. Finally, we discuss how PCOS may interact with ageing and ethnicity to modulate cardiovascular risk secondary to autonomic dysfunction.
Adams et al. (Sat,) conducted a review in Polycystic ovary syndrome (PCOS). Autonomic dysfunction in polycystic ovary syndrome may drive cardiovascular risk, with evidence suggesting increased sympathetic activity and reduced vagal control of heart rate.