Elevated Anxiety and Depression Scores are associated with reduced heart rate variability in women with polycystic ovary syndrome

Objective: Polycystic ovary syndrome (PCOS) affects approximately 10% of women and can impact endocrine, metabolic, cardiovascular, and emotional parameters. This cross-sectional study aimed to investigate the relationship between cardiac autonomic modulation, assessed by heart rate variability (HRV), and symptoms of anxiety and depression in women with PCOS. Methods: Ninety-five women diagnosed with PCOS according to the Rotterdam Consensus criteria were included by convenience sampling. Groups were stratified according to the presence of possible or probable anxiety and depression. Clinical, biochemical, anthropometric parameters, and body composition by dual-energy X-ray absorptiometry were evaluated. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Hemodynamic variables and HRV indices were recorded in the supine and standing positions. Results: Groups with possible or probable anxiety or depression scores exhibited associations with indices indicating lower HRV. A significant negative correlation was observed between the standard deviation of NN intervals and depression in the supine position and between variance and depression. Additionally, participants with possible or probable anxiety scores showed reduced parasympathetic modulation. No significant differences were observed in body composition parameters between groups. Conclusion: Symptoms of anxiety and depression in women with PCOS were associated with reduced HRV. These findings suggest a potential link between emotional disturbances and autonomic imbalance in this population, emphasizing the relevance of integrated clinical assessment. Future studies should investigate whether emotional or psychological therapies can improve cardiac autonomic modulation in women with PCOS.