Polycystic ovary syndrome and cardiovascular risk

Polycystic ovary syndrome (PCOS) is a common endocrine disease in women of reproductive age. In addition to hyperandrogenism, impaired ovulation and fertility, PCOS is associated with an increased detection of cardiovascular risk factors such as obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, arterial hypertension, and obstructive sleep apnea. The initial stages of the atherosclerotic process are also well documented in women with PCOS. However, data from prospective studies on the end points of cardiovascular morbidity and mortality are scarce and controversial. Perhaps this is due to the fact that PCOS is a heterogeneous group of endocrine, metabolic and reproductive disorders, and different authors consider various combinations of these disorders as the syndrome. Different phenotypes of PCOS may be associated with different cardiovascular risk. Women with a “complete” phenotype (a combination of all three PCOS diagnostic criteria) and with the predominant hyperandrogenism have higher risk. According to a number of studies, obesity affects more than half of women with PCOS and contributes the most to the increased risk of type 2 diabetes mellitus. Despite the weakness of the evidence regarding the association of PCOS with cardiovascular morbidity and mortality, most international organizations recommend active screening for cardiovascular risk factors in women with PCOS.