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September 23, 2020Frontiers in Medicine35 citationsOpen Access

Hypertension Risk in Young Women With Polycystic Ovary Syndrome: A Nationwide Population-Based Cohort Study

CWCheng-Hsuan WuLCLu‐Ting ChiuYCYu‐Jun Chang

Key Result

Polycystic ovary syndrome increased the risk of developing hypertension by 62% compared to women without the condition (adjusted HR 1.62).

Study Design

Type

Cohort (n=103,260)

Structured PICO

Does polycystic ovary syndrome increase the risk of developing hypertension in young women?

P
Population
103,260 women (20,652 with polycystic ovary syndrome and 82,608 age-matched controls without PCOS), mean age 29 years, from the National Health Insurance Research Database in Taiwan.
I
Intervention
Polycystic ovary syndrome (PCOS) diagnosis (exposure)
C
Comparator
Women without PCOS, matched 4:1 by age and index year
O
Outcome
New diagnosis of hypertension (ICD-9-CM codes 401-405) with at least two outpatient visits or at least one hospitalization recordhard clinical

Young women with PCOS have a significantly increased risk of developing hypertension, particularly when comorbid with diabetes or hyperlipidemia, highlighting the need for early cardiovascular screening.

Main Result

Effect estimate: HR 1.62 (95% CI 1.48-1.76)

Absolute Event Rate: 7.85% vs 4.23%

p-value: p=<0.001

Limitations

  • Lack of baseline information such as BMI, smoking, alcohol consumption, and family history
  • Parity is not recorded in the database
  • Did not compare different PCOS phenotypes
  • Retrospective design
  • The NHIRD does not provide baseline information on patients, such as BMI, smoking, alcohol consumption, and family history.
  • Parity is not recorded in the database.
  • Did not compare the different PCOS phenotypes.
  • Retrospective design.

Abstract

Objective: A number of publications have assessed the prevalence of hypertension in polycystic ovary syndrome (PCOS) patients with inconclusive results. Since in general populations the occurrence of hypertension is related to age and comorbidities, we investigated the incidence rate and hazard ratios (HRs) of hypertension between healthy subjects and young women with PCOS as well as comorbidities. Methods: We conducted a population-based retrospective cohort study by using the National Health Insurance Research Database in Taiwan. The cohort included women with the diagnosis of PCOS between 2000 and 2012. Those without PCOS were selected as the control group at a ratio of 4:1 by an age-matched systematic random-sampling method. Cox proportional hazard regression analysis was used to determine the effects of PCOS on the risks of developing hypertension. Stratification analysis was performed to elucidate the interaction among PCOS and the comorbidities, which affect the incidence of hypertension. Results: The PCOS cohort consisted of 20,652 patients with PCOS and the comparison cohort consisted of 82,608 matched patients without PCOS. There was no difference in the distribution of age between the PCOS cohort and the comparison cohort (29.1 ± 6.8 vs. 29.0 ± 6.5, p = 0.32). The incidence rates of hypertension were 7.85 and 4.23 per 1000 person-years in the PCOS and comparison groups, respectively. A statistically significant higher risk of hypertension was found in the PCOS cohort (adjusted HR = 1.62, 95% confidence interval = 1.48 - 1.76) than in the comparison cohort. After a joint analysis of comorbidities, the adjusted HR of hypertension was 9.44 (95% confidence interval = 7.27 - 12.24) for PCOS patients with comorbidities of diabetes mellitus (DM) and hyperlipidemia compared with women with neither PCOS nor DM and hyperlipidemia. Conclusion: The risk of developing hypertension in young women with PCOS was higher than in controls in this cohort study. The comorbidities of DM and hyperlipidemia could interact with PCOS patients and further increase the risk of hypertension. An earlier screening for hypertension and comorbidities in patients with PCOS may be warranted, even in young women.

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Cite This Study

Wu et al. (2020) conducted a cohort in Polycystic Ovary Syndrome (n=103,260). Polycystic Ovary Syndrome vs. Women without PCOS was evaluated on New diagnosis of hypertension (HR 1.62, 95% CI 1.48-1.76, p=<0.001). Polycystic ovary syndrome increased the risk of developing hypertension by 62% compared to women without the condition (adjusted HR 1.62).

synapsesocial.com/papers/6a1ad8be49c6765e3885fdachttps://doi.org/10.3389/fmed.2020.574651
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