Polycystic ovary syndrome linked to higher risk of heart disease

By Michele Dula Baum
CNN.com Health and Food Writer

(CNN) -- Women who have polycystic ovary syndrome may also have a higher risk of heart disease, according to a new study.

"Because it appears that PCOS may cause atherosclerosis, these women may represent the largest female group at high risk for the development of early onset coronary artery disease," said Evelyn Talbott, an associate professor of epidemiology at the University of Pittsburgh in Pennsylvania. "It is important for physicians to recognize these symptoms as signs of a broader, chronic disorder and treat it accordingly, with early lifestyle interventions and/or medications that will reduce cardiovascular disease risks."

Polycystic ovary syndrome is one of the most common endocrine disorders, affecting some 6 percent of women of reproductive age. Most seek medical help because of infertility, irregular menstruation or other hormonal problems such as acne and unusual hair growth. The disease is characterized by multiple abnormal cysts in the ovaries.

RESOURCES The Hormone Foundation Organon     TRANSCRIPT Read a transcript of our chat about PCOS with endocrinologist Robert Jaffe

But evidence shows that the disorder can be more serious, said lead researcher Talbott, whose study is in the November issue of Arteriosclerosis, Thrombosis and Vascular Biology, a journal of the American Heart Association.

Along with reproductive problems, women who have polyscystic ovary syndrome tend to have other metabolic abnormalities, including high levels of insulin, obesity, LDL or "bad cholesterol," and high blood pressure. All contribute to or are risk factors for coronary artery disease.

"There were several studies in the early '90s looking at all the risk factors, but this is the first study of any magnitude that has looked at the association" between PCOS and atherosclerosis, said Talbott. Atherosclerosis occurs when fatty deposits called plaques develop on inner arterial walls, resulting in blockages, which can lead to heart attack and stroke.

"We have a good marker, non-invasively, and do see increased atherosclerosis -- also more plaque and more severe plaque," said Talbott.

Researchers studied 125 PCOS patients and 142 women with normal ovarian function who had similar demographic characteristics. Ultrasound examination of the carotid arteries in the neck revealed that nearly 21.6 percent of PCOS women had plaque buildup, compared with 15.5 percent of those in the control group. In addition, those over the age of 45 had more significant plaque than their peers.

"Forty-five is still fairly young," noted Talbott. Still, women's overall heart disease risk increases at menopause. By 45, most women are in the early stages of menopause.

In addition to looking for plaques, researchers measured arterial wall thickness, another indicator of atherosclerosis and early heart disease. Arterial wall thickness also was significantly increased for women over 45 with PCOS, they found.

What this means, explained Talbott, is that PCOS sufferers have increased risk reaching earlier into their lives than most people do. Even thinner women with PCOS had increased atherosclerosis and associated conditions.

"Imagine the increase in risk factors at age 20 or 25," she said. "I believe that over time, it takes its toll. It's a smoking gun, so to speak."

The study points to the necessity for women and their doctors to be aware of PCOS and its possible consequences, said Talbott, adding that she feels a PCOS diagnosis is often overlooked.

A new $1.7-million study funded by the National Institutes of Health is set to begin in March using computed tomography scanning to evaluate calcification of coronary arteries in women with PCOS. The evaluation, known as "ultra-fast spiral CT," will be repeated in several years to note progression, said Talbott.

"These are risk factors that can be intervened upon early. The main thing, I would hope, is that as these women come in for whatever reason, clinicians will check for lipids, blood pressure, and these other factors," she said. "Really, there's no reason why they should wake up at 45 or 50 and say 'Why didn't somebody tell me about this?'"

Diabetes joins list of heart disease risk factors
September 2, 1999
Heart disease top killer of women
May 10, 1999

Medline: Information on ovarian cysts
University of Pittsburgh Health System
University of Pittsburgh: Evelyn Talbott faculty page
Arteriosclerosis, Thrombosis and Vascular Biology Journal

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