Are pregnant women with PCOS at risk for heart disease?

It causes irregular periods, an excess of male hormones (male hormones), and sometimes infertility.

Building on previous research that found PCOS to be linked to future risks of cardiovascular disease, the new findings suggest it can also significantly increase heart problems in pregnant women during pregnancy. at birth.


These problems include preeclampsia (dangerous levels of high blood pressure with organ damage), postpartum cardiomyopathy (weak or enlarged heart), heart failure, abnormal heart rhythms, and venous thrombosis (thrombosis). blood clots), compared with women without PCOS.

“Usually, women with PCOS are concerned about the immediate effects, like irregular menstrual cycles, excess body hair, weight gain and acne,” says Dr. Erin Michos. Long-term cardiovascular complications are also a serious problem.” associate professor of medicine at Johns Hopkins University School of Medicine and the study’s corresponding author.

Heart disease risk in pregnant women with PCOS

Michos said the new study should encourage women with PCOS to live a heart-healthy lifestyle before, during, and after pregnancy to reduce the risk of adverse outcomes.

For the study, the researchers analyzed data collected on more than 17 million births in the US between 2002 and 2019 drawn from the National Inpatient Sample. Of those who had to be hospitalized for delivery, 195,675 had PCOS.

The prevalence of PCOS – and obesity among those with hormone disorders – increased significantly during the study period. The number of women with PCOS increased from 569 per 100,000 deliveries in 2002 to 15,349 per 100,000 deliveries in 2019. During the same time period, obesity among women with PCOS also spiked from 5.7% to 28.2%. Michos and colleagues note that some of the increase in PCOS may be due to better detection and diagnostic capabilities.

After adjusting for age, race, and other disorders unrelated to PCOS, insurance, and income, PCOS remained an independent predictor of cardiac complications during childbirth compared with women who did not. hormone disorders.

Complications included preeclampsia, with a 56% increased comparative risk; heart failure, 76% increased risk; abnormal heart rhythms, with a two-fold higher risk; heart failure, with a 79% higher risk; and an 82% higher risk of forming a blood clot.

Women with PCOS are generally older (31 versus 28) and have higher rates of diabetes, obesity, and high cholesterol. The study also found that black women with PCOS were at increased risk for preeclampsia and other adverse outcomes.

“Currently, the overall goal is to reduce increased mortality among pregnant women in the US, with a mission to identify risk factors. Our study shows that PCOS is indeed a risk factor. causes acute cardiac complications at the time of delivery and should be reported by Salman Zahid, MD, a resident in the Residency program of Rochester General Hospital in Rochester, New York, and lead author of the study. save, said.

“We want to emphasize the importance of optimizing the cardiovascular health of women with PCOS with prevention efforts, particularly Black women and lower socioeconomic groups because we believe that it is these populations that are most vulnerable and will benefit most from the intervention.”

In a separate meta-analysis (an analysis combining multiple studies) published May 16 in Women’s Health MagazineMichos and her colleagues found that Women with PCOS are twice as likely to develop coronary artery calcification (CAC), a marker of subclinical atherosclerosis (an early marker of atherosclerosis, the accumulation of fat and cholesterol in the artery walls). CAC occurs when plaque builds up in the arteries and becomes calcified. It is a marker of atherosclerosis, even in the absence of symptoms, and a reliable predictor of cardiovascular disease risk.

Women with PCOS are at increased risk for dyslipidemia (lipid imbalance), type 2 diabetes, hypertension, and heart disease. Early detection of CAC in women with PCOS is key to preventing future cardiovascular disease risk, says Michos.

“These findings suggest that coronary calcium should be considered a risk factor for heart disease for women over the age of 40,” says Michos. “Do women with PCOS need statins? If they have coronary calcium suggesting atherosclerosis, they will. This could be a risk tool for PCOS stratification.”

These two studies together highlight the cardiovascular risks associated with PCOS, both in pregnancy and in the long term, Michos emphasized. Screening for cardiovascular risk factors remains important in this patient population, but cardiovascular risk reduction can be achieved with a combination of healthy lifestyle choices and drug treatment, when indicated, as a precaution.

Source: Eurekalert

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