Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society.
OBJECTIVE
Women with polycystic ovary syndrome (PCOS) often have cardiovascular disease (CVD) risk factors. The Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society created a panel to provide evidence-based reviews of studies assessing PCOS-CVD risk relationships and to develop guidelines for preventing CVD.


METHODS
An expert panel in PCOS and CVD reviewed literature and presented recommendations.


METHODS
Only studies comparing PCOS with control patients were included. All electronic databases were searched; reviews included individual studies/databases, systematic reviews, abstracts, and expert data. Articles were excluded if other hyperandrogenic disorders were not excluded, PCOS diagnosis was unclear, controls were not described, or methodology precluded evaluation. Inclusion/exclusion criteria were confirmed by at least two reviewers and arbitrated by a third.


METHODS
Systematic reviews of CVD risk factors were compiled and submitted for approval to the AE-PCOS Society Board.


CONCLUSIONS
Women with PCOS with obesity, cigarette smoking, dyslipidemia, hypertension, impaired glucose tolerance, and subclinical vascular disease are at risk, whereas those with metabolic syndrome and/or type 2 diabetes mellitus are at high risk for CVD. Body mass index, waist circumference, serum lipid/glucose, and blood pressure determinations are recommended for all women with PCOS, as is oral glucose tolerance testing in those with obesity, advanced age, personal history of gestational diabetes, or family history of type 2 diabetes mellitus. Mood disorder assessment is suggested in all PCOS patients. Lifestyle management is recommended for primary CVD prevention, targeting low-density and non-high-density lipoprotein cholesterol and adding insulin-sensitizing and other drugs if dyslipidemia or other risk factors persist.
Wild
Robert A
RA
Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
Carmina
Enrico
E
Diamanti-Kandarakis
Evanthia
E
Dokras
Anuja
A
Escobar-Morreale
Hector F
HF
Futterweit
Walter
W
Lobo
Rogerio
R
Norman
Robert J
RJ
Talbott
Evelyn
E
Dumesic
Daniel A
DA
D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000401:mortality; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D018570:Risk Assessment; D012307:Risk Factors; D049629:Waist-Hip Ratio