BACKGROUND AND PURPOSE:

• Women with polycystic ovary syndrome (PCOS) have increased risk factors for cardiovascular disease (CVD)
  • Whether this translates to an increased risk for cardiovascular events or related mortality is unknown
• Forslund et al. (European Journal of Obstetrics and Gynecology, 2022) assessed morbidity and mortality among women with a diagnosis of PCOS

METHODS:

• Prospective cohort study
  • Follow up in 2019 of a prospective cohort of women with PCOS (1956 to 1965)
  • Long-term study, with follow-up previously in 1987 and 2008
• Participants
  • 72 to 91 years
• Exposures
  • PCOS (Rotterdam criteria)
  • Age matched non-PCOS reference group
• Study design
  • For deceased women register data was used
  • Interviews were conducted for women, and medical records were studied
• Primary outcomes
  • Mortality
  • Cardiovascular morbidity

RESULTS:

• Women with PCOS: 35 | Age-matched references: 99
  • Mean age: 81 years
• There was no difference in mortality among women with PCOS
  • All-cause mortality: HR 1.10 (95% CI, 0.66 to 1.98)
  • CVD-related mortality: HR 1.65 (95% CI, 0.66 to 4.29)
• There was also no difference in cardiovascular-related morbidity among women with PCOS
  • All CVD: HR 1.21 (95% CI, 0.66 to 2.20)
  • Hypertension: HR 1.76 (95% CI, 0.99 to 3.52)
  • Type 2 diabetes: HR 1.65 (95% CI, 0.77 to 3.74)
• There were also no differences in the following between the women with PCOS and the reference group
  • Blood lipids
  • Glucose levels
  • Insulin levels
  • Thyroid hormone levels
• Comparing baseline data from the deceased and living women with PCOS, no differences were found regarding
  • Age
  • Menopausal age
  • BMI
  • Homeostasis model assessment of insulin resistance
  • Free androgen index
  • Total testosterone
  • SHBG levels
• Deceased women with PCOS had a higher waist to hip ratio at baseline (P<0.01)
  • PCOS: 0.87
  • Reference: 0.80

CONCLUSION:

• There was no increased risk of CVD or mortality in this cohort of elderly women with PCOS
• While women with PCOS have risk factors associated with CVD in perimenopause, these do not seem to be linked to increased risk later in life
• The authors state

In conclusion, this 32-year follow-up up to a mean age above 80 years of the Gothenburg PCOS cohort and their age-matched controls, similar in BMI, showed no increase in all-cause mortality or CVD morbidity

Learn More – Primary Sources:

Morbidity and mortality in PCOS: A prospective follow-up up to a mean age above 80 years

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