Effects of metformin versus ethinyl-estradiol plus cyproterone acetate on ambulatory blood pressure monitoring and carotid intima media thickness in women with the polycystic ovary syndrome.
OBJECTIVE
To compare the effects of metformin versus an antiandrogenic contraceptive pill on ambulatory blood pressure monitoring (ABPM) and carotid intima media thickness (CIMT) in women with polycystic ovary syndrome (PCOS).


METHODS
Clinical randomized trial.


METHODS
Academic hospital.


METHODS
Thirty-four consecutive PCOS patients.


METHODS
PCOS patients randomized to oral treatment with metformin (n = 19) or with Diane(35) Diario pill (n = 15) for 24 weeks.


METHODS
ABPM recordings and ultrasound measurements of CIMT as marker of subclinical atherosclerosis obtained at baseline and after treatment.


RESULTS
Metformin resulted in reductions in daytime and 24-hour average systolic and diastolic blood pressure whereas Diane(35) Diario induced a slight increase in these parameters. Compared with a nonhyperandrogenic control group, the increased CIMT values of PCOS patients decreased to the normal range after treatment with either metformin or Diane(35) Diario.


CONCLUSIONS
Metformin treatment decreased daytime ABPM recordings whereas Diane(35) Diario exerted the opposite effect. The safer blood pressure profile of metformin should be considered in PCOS patients who present with a history of hypertension or who are at risk for this disorder. Treatment with either Diane(35) Diario or metformin improved CIMT mean values.
Department of Endocrinology, Hospital Universitario Ramón y Cajal and Universidad de Alcalá, Madrid, Spain.
Manuel
M
Luque-Ramírez
Covadonga
C
Mendieta-Azcona
Francisco
F
Alvarez-Blasco
Héctor F
HF
Escobar-Morreale
D000328:Adult; D000726:Androgen Antagonists / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D002339:Carotid Arteries / Q000187:drug effects / Q000473:pathology*; D017373:Cyproterone Acetate / Q000627:therapeutic use*; D004967:Estrogens / Q000627:therapeutic use; D004997:Ethinyl Estradiol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008687:Metformin / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000503:physiopathology*; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology*; D055815:Young Adult
D000726:Androgen Antagonists; D004967:Estrogens; D007004:Hypoglycemic Agents; D004997:Ethinyl Estradiol; D017373:Cyproterone Acetate; D008687:Metformin