SAT-015 Incidence and Predictors of Hypertension in a Cohort of Australian Women with and Without Polycystic Ovary Syndrome

Abstract Background: There is a lack of longitudinal studies exploring the relationships between polycystic ovary syndrome (PCOS) and hypertension, in population-based settings. Objectives: To identify predictors of hypertension in women with and without PCOS and the relationship to body mass of index (BMI). Methods: We undertook a community-based cohort analysis of the Australian Longitudinal Study (ALSWH) data conducted on 9,688 young adult women, aged 21–42 years from 2000–2015. We conducted survival analysis using the Cox Proportional Hazards Model to identify predictors and person-time analysis to calculate incidence rates of hypertension. Results: Overall, 9,508 women were followed for 145,159 PY (person-years) and 1,556 (16.37%) women developed hypertension during the follow-up. The incidence of hypertension was significantly higher (p = 0.001) among women with PCOS (17/1000 PY) compared to women without (11/1000 PY). There were significant differences in time to hypertension development between women +/- PCOS. Hypertension was observed among women with PCOS from early adulthood and across BMI categories. The difference in the actual number of incident hypertension cases (incidence rate difference (IRD)) between women with and without PCOS, was fourfold higher (15.8 vs. 4.3 respectively) among women who were obese at baseline, compared to age-matched lean women. PCOS was independently associated with hypertension with a 36% greater risk, adjusting for BMI and other confounders. Conclusion: Our results suggest women with PCOS as more likely to develop hypertension from early adulthood, independent of BMI and with risk exacerbated by obesity.

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Incidence and Predictors of Hypertension in a Cohort of Australian Women with and without Polycystic Ovary Syndrome

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab134 ◽

2021 ◽

Author(s):

Anju E Joham ◽

Nadira S Kakoly ◽

Helena J Teede ◽

Arul Earnest

Keyword(s):

Polycystic Ovary Syndrome ◽

Proportional Hazards Model ◽

Polycystic Ovary ◽

Large Population ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Obese Women ◽

Ovary Syndrome ◽

Co Morbidity

Abstract Context There are limited studies in large population-based settings examining the relationship between polycystic ovary syndrome (PCOS) and hypertension. Objective To evaluate incidence of hypertension among women with and without PCOS over a 15-year period. Design Secondary analysis of longitudinal data from the Australian Longitudinal Study on Women’s Health. Setting General community Participants Women were randomly selected from the national health insurance database. 9,508 women, aged 21-42 years, were followed up from 2000–2015 Methods We conducted survival analysis using Cox proportional hazards model to identify predictors of hypertension and person-time analysis to calculate incidence rates of hypertension. Results 9,508 women were followed for 145,159 PY (person years) and 1,556 (16.37%) women developed hypertension during follow-up. The incidence of hypertension was significantly higher (p=0.001) among women with PCOS (17/1000 PY) compared to women without (10/1000 PY). 8,223 women had known PCOS status, of which 681 women (8.3%) had self-reported physician diagnosed PCOS. Incidence rate difference of hypertension (cases attributable to PCOS) was four-fold higher (15.8 vs. 4.3 respectively /1000PY) among obese women with PCOS compared to age-matched lean women with PCOS. PCOS was independently associated with 37% greater risk of hypertension (HR 1.37, 95%CI 1.14-1.65), adjusting for body mass index (BMI), family history of hypertension, occupation and co-morbidity with type 2 diabetes. Conclusions Women with PCOS are more likely to develop hypertension from early adulthood, independent of BMI, which is further exacerbated by obesity. Including PCOS in hypertension risk stratification assessments may aid efforts in early identification of the disorder.

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Are Young Adult Women With Polycystic Ovary Syndrome Slipping Through the Healthcare Cracks?

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-4190 ◽

2014 ◽

Vol 99 (5) ◽

pp. 1583-1585 ◽

Cited By ~ 17

Author(s):

Anuja Dokras ◽

Selma Feldman Witchel

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Early Adulthood ◽

Healthcare Providers ◽

Physician Education ◽

Adult Women ◽

Ovary Syndrome ◽

Presenting Symptoms ◽

Increased Risk ◽

Entry Points

Polycystic ovary syndrome (PCOS) is a common endocrine disorder often diagnosed in adolescence or early adulthood. In adolescence, the many similarities between normal features of puberty and symptoms of PCOS make it challenging to confirm the diagnosis. Even among adult women, the changing definitions of PCOS may lead to inaccurate diagnoses. Women may present with a variety of symptoms to different healthcare providers and may be treated only for the presenting symptoms without evaluation of the syndrome and its associated morbidities. Timely evaluations, accurate diagnosis, appropriate interventions, and multidisciplinary healthcare teams can be valuable because women with PCOS have an increased risk for obesity, impaired glucose tolerance, diabetes, dyslipidemia, metabolic syndrome, infertility, endometrial cancer, and anxiety and mood disorders. Appropriate transition of care for the adolescent from pediatric to adult healthcare providers should include education of the patient and her parents regarding the chronic nature of the syndrome and the need for continued follow-up. Girls with symptoms suggestive of PCOS who fail to fulfill diagnostic criteria should undergo prolonged observation. Early identification of PCOS at different entry points in the healthcare system will require physician education and improved access.

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Risk of Psoriasis in Patients with Polycystic Ovary Syndrome: A National Population-Based Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm9061947 ◽

2020 ◽

Vol 9 (6) ◽

pp. 1947

Author(s):

Tsung-Hsien Lee ◽

Cheng-Hsuan Wu ◽

Ming-Li Chen ◽

Hei-Tung Yip ◽

Chun-I Lee ◽

...

Keyword(s):

Cohort Study ◽

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Population Based ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Control Group ◽

Research Database ◽

Ovary Syndrome ◽

Pcos Group

Both polycystic ovary syndrome (PCOS) and psoriasis are associated with insulin resistance and metabolic syndrome. Nonetheless, the incidence of psoriasis in patients with PCOS is unclear. We used the Longitudinal Health Insurance Research Database (LHID) in Taiwan from 2000 to 2012 to perform a retrospective population-based cohort study to elucidate the occurrence of psoriasis in PCOS patients. Patients with PCOS without psoriasis in the index year (the year of PCOS diagnosis) were recruited as the PCOS group. Those without PCOS nor psoriasis (control group) were selected using propensity score matching at a ratio of 4:1. Hazard ratios (HRs) were obtained using the Cox proportional hazards regression model. In total, 4707 and 18,828 patients were included in the PCOS and control groups, respectively. The incidence rates of psoriasis in the control and PCOS groups were 0.34 and 0.70 per 1000 person-years, respectively. The risk of psoriasis was higher in the PCOS group by an HR of 2.07 (95% confidence interval [CI] = 1.25–3.43) compared with the control group. In conclusion, the incidence of psoriasis in the PCOS group was higher than that in the control group. Further studies should be conducted to investigate the mechanism underlying the association, and to benefit the long-term management of patients with PCOS.

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