Cardiovascular Disease and Risk Factors in PCOS Women of Postmenopausal Age: A 21-Year Controlled Follow-Up Study

Context: Polycystic ovary syndrome (PCOS) is associated with the metabolic syndrome and, consequently, with a potentially increased risk of cardiovascular disease (CVD) and related mortality later in life. Studies regarding CVD and mortality in PCOS women well into the postmenopausal age are lacking. Objective: Our objective was to examine whether postmenopausal PCOS women differ from controls regarding cardiovascular risk factors, myocardial infarction (MI), stroke and mortality. Design and Setting: We conducted, at a university hospital, a prospective study of 35 PCOS women (61-79 yr) and 120 age-matched controls. The study was performed 21 yr after the initial study. Participants: Twenty-five PCOS women (Rotterdam criteria) and 68 controls participated in all examinations. Data on morbidity were based on 32 of 34 PCOS women and on 95 of 119 controls. Interventions: Interventions included reexamination, interviews, and data from the National Board of Health and Welfare and from the Hospital Discharge Registry. Main Outcome Measures: Blood pressure, glucose, insulin, triglycerides, total cholesterol, high- and low-density lipoprotein, apolipoprotein A1 and B, fibrinogen, and plasminogen activator inhibitor antigen were studied. Incidences of MI, stroke, hypertension, diabetes, cancer, cause of death, and age at death were recorded. Results: PCOS women had a higher prevalence of hypertension (P = 0.008) and higher triglyceride levels (P = 0.012) than controls. MI, stroke, diabetes, cancer, and mortality prevalence was similar in the two cohorts with similar body mass index. Conclusions: The well-described cardiovascular/metabolic risk profile in pre- and perimenopausal PCOS women does not entail an evident increase in cardiovascular events during the postmenopausal period. (J Clin Endocrinol Metab 96: 3794-3803, 2011)