Study Links PCOS With Higher Cardiovascular Disease Risk

Key Takeaways

• Cardiovascular disease risk was higher in women with PCOS and remained elevated after adjustment for BMI or obesity and education. The association was also present among women with BMI below 25 kg/m2 and no type 2 diabetes.
• The findings support screening awareness and may reflect longer-term risk patterns within PCOS beyond fertility-related concerns.

A Nordic register-based study showed higher cardiovascular disease risk in women with PCOS than in controls, with a pooled adjusted hazard ratio of 1.32 (1.25; 1.39).

The comparison included women aged 15 to 50 years with PCOS and age-matched controls from Denmark, Finland, and Sweden, followed for about a decade. The analysis tracked cardiovascular outcomes prospectively through national health registers.

The study population included 127,517 women with PCOS and 587,810 age-matched controls from Denmark, Finland, and Sweden. National cohorts comprised 27,298 women with PCOS and 135,019 controls in Denmark, 20,765 and 59,122 in Finland, and 79,454 and 393,669 in Sweden. Median age at cohort entry was 28 years in Denmark and 29 years in Finland and Sweden. Follow-up averaged about 10 years, and median follow-up ranged from 8.0 to 10.0 years. Cardiovascular disease was defined by ICD-10 codes for major adverse cardiac events, pulmonary embolism, and deep venous thrombosis in this prospective population-based register comparison.

Country-specific unadjusted hazard ratios for cardiovascular disease were 1.30 (1.20; 1.41) in Denmark, 1.45 (1.31; 1.60) in Finland, and 1.52 (1.44; 1.60) in Sweden. The country estimates differed in magnitude, but each pointed to higher cardiovascular risk in women with PCOS.

In women with BMI below 25 kg/m2 and no type 2 diabetes, the adjusted hazard ratio was 1.40 (1.26; 1.55). The association remained statistically significant after adjustment for obesity or BMI and education across the analyzed cohorts. The subgroup finding indicated that the excess was not limited to women with higher adiposity or established diabetes.

The investigators said the findings highlight the importance of regular medical screenings. They also suggested that PCOS may not represent one uniform long-term profile, but may encompass different patterns of diabetes and cardiovascular risk.