Polycystic ovary syndrome and early-onset preeclampsia: reproductive manifestations of increased cardiovascular risk.
OBJECTIVE
Primary prevention of cardiovascular disease (CVD) in women is a major healthcare issue. Detection of premenopausal women with increased risk of CVD could enhance prevention strategies and reduce first event-related morbidity and mortality. In this study, we argue that an unfavorable metabolic constitution in women may present itself early in life as a reproductive complication, such as polycystic ovary syndrome (PCOS) and preeclampsia. We evaluated the cardiovascular risk of women with a history of early-onset preeclampsia and women with PCOS and assessed their need for implementation of early risk factor-reduction strategies.


METHODS
We performed a standardized evaluation of 240 women with a history of early-onset preeclampsia and 456 women diagnosed with PCOS for established major CVD risk factors. Metabolic syndrome characteristics were analyzed per body mass index category.


RESULTS
Mean age was 30.6 and 29.0 years for women with preeclampsia and PCOS, respectively. High percentages of metabolic syndrome were found in both groups (preeclampsia group, 14.6%; and PCOS group, 18.4%), with an incidence of greater than 50% in both groups of women if body mass index was greater than 30 kg/m. Overall, more than 90% of the women qualified for either lifestyle or medical intervention according to the American Heart Association guideline for CVD prevention in women.


CONCLUSIONS
Women with PCOS and early-onset preeclampsia already show an unfavorable cardiovascular risk profile with high need for lifestyle or medical intervention at a young age. We therefore recommend an active role of the gynecologist in routine screening and follow-up of women with reproductive conditions linked to future cardiovascular risk.
Veltman-Verhulst
Susanne M
SM
Departments of Reproductive Medicine and Gynecology, University Medical Center, Utrecht, The Netherlands. s.m.verhulst@umcutrecht.nl
van Rijn
Bas B
BB
Westerveld
H Egbertine
HE
Franx
Arie
A
Bruinse
Hein W
HW
Fauser
Bart C J M
BC
Goverde
Angelique J
AJ
D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases; D005260:Female; D006801:Humans; D015994:Incidence; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D009765:Obesity / Q000150:complications*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011225:Pre-Eclampsia; D011247:Pregnancy; D012307:Risk Factors