Polycystic Ovary Syndrome and Cardiovascular Risk: Mechanisms, Clinical Evidence, and Prevention Strategies
Abstract
Polycystic ovary syndrome (PCOS) affects an estimated 11-13% of reproductive-age women worldwide and is increasingly recognized as a condition with significant cardiometabolic abnormalities, beyond its reproductive manifestations. This focused narrative review synthesizes contemporary evidence on the mechanistic, subclinical, and clinical links between PCOS and cardiovascular disease. We examine how hyperandrogenism may contribute to insulin resistance and related abnormalities, including dyslipidemia, hypertension, metabolic dysfunction-associated steatotic liver disease, and endothelial dysfunction, which collectively may increase atherosclerotic risk. Chronic low-grade inflammation and sympathetic overactivation are identified as additional, body mass index-independent amplifiers of this risk. Subclinical markers of vascular dysfunction, including increased carotid intima-media thickness, elevated coronary artery calcium, and elevated biomarkers such as asymmetric dimethylarginine and plasminogen activator inhibitor-1, are consistently elevated in women with PCOS relative to controls. A 2024 meta-analysis of over 300,000 women with PCOS demonstrates pooled odds ratios of 2.50 for myocardial infarction and 1.71 for stroke. Importantly, cardiovascular risk is not limited to women with elevated body mass index; lean women with PCOS carry a substantial and underappreciated metabolic burden. Current risk stratification tools inadequately account for PCOS, and cardiology…
Read the paper
Related studies
- Increased expression of circulating miRNA-93 in women with polycystic ovary syndrome may represent a novel, non-invasive biomarker for diagnosis
- Identification of key genes associated with polycystic ovary syndrome (PCOS) and ovarian cancer using an integrated bioinformatics analysis
- Identification of key pathways and genes in polycystic ovary syndrome via integrated bioinformatics analysis and prediction of small therapeutic molecules
- Regulation of Androgen Receptor Expression Alters AMPK Phosphorylation in the Endometrium: In Vivo and In Vitro Studies in Women with Polycystic Ovary Syndrome
- Effect of oral administration of low-dose follicle stimulating hormone on hyperandrogenized mice as a model of polycystic ovary syndrome
- Systems pharmacology to investigate the interaction of berberine and other drugs in treating polycystic ovary syndrome
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.