There is an association between polycystic ovary syndrome (PCOS) and the metabolic syndrome. It has been predicted that women with PCOS are potentially at increased risk of cardiovascular disease (CVD) and related mortality during postmenopausal age. Because no prior studies have examined CVD and mortality in PCOS women well into the postmenopausal period, it is unclear whether this predicted increased risk of morbidity/mortality in postmenopausal PCOS women is accurate.
The aim of this prospective long-term follow-up study was to compare cardiovascular risk factors, myocardial infarction (MI), stroke, and mortality in postmenopausal women with PCOS and control subjects. Participants were 35 women with PCOS (aged 61–79 years) and 120 age-matched control subjects initially recruited and examined in 1987, who were studied again 21 years later in 2008. A total of 25 women with PCOS (meeting Rotterdam criteria) and 68 aged-matched control subjects, completed the entire investigation. Morbidity data were based on 32 of 34 (94%) women with PCOS and 95 of 119 control subjects. The investigation included re-examinations, structured medical history interviews, as well as data on MI, stroke, hypertension, diabetes, and cancer morbidity from the Hospital Discharge Registry, and on morbidity/mortality in diseased women from the National Board of Health and Welfare. The following were analyzed in fasting venous blood samples: insulin and glucose concentrations, lipid levels (cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, apolipoprotein A1 and B), fibrinogen, and plasminogen activator inhibitor antigen. Blood pressure was also measured. Incidences of MI, stroke, hypertension, diabetes, malignancy, cause of death, and age at death were determined.
There was a higher prevalence of hypertension (P = 0.008) and higher triglyceride levels (P = 0.012) among postmenopausal women with PCOS compared with control subjects. No differences in the incidence of MI, stroke, diabetes, cancer, and mortality were found in the 2 cohorts with similar weight and body mass index.
These findings suggest that women with PCOS are at no increased risk of the predicted increase in cardiovascular events during the postmenopausal period.