Diabetes and cardiovascular events in women with polycystic ovary syndrome: a 20-year retrospective cohort study

Clin Endocrinol (Oxf). 2013 Jun;78(6):926-34. doi: 10.1111/cen.12068. Epub 2013 Apr 6.


Objective: Women with polycystic ovary syndrome (PCOS) are potentially at increased risk of cardiovascular (CV) diseases due to well-established risk factors, including insulin resistance, obesity and type 2 diabetes mellitus (T2DM). However, data showing excess CV events in this population are still lacking. We investigated the incidence and prevalence of CV events in a cohort of women with PCOS.

Design: Retrospective cohort study (total follow-up >12,000 person-years).

Setting: Leicester, Leicestershire and Rutland (Total Female population of 434,859), UK.

Participants: Two thousand three hundred and one women with PCOS (mean age = 29.6 years) attending a speciality clinic in Leicestershire, UK.

Main outcomes measures: T2DM, myocardial infarction (MI), angina, heart failure (HF), stroke and CV-related death.

Results: Incidence of T2DM, MI, angina, HF, stroke and CV death was respectively 3.6, 0.8, 1.0, 0.3, 0.0 and 0.4 per 1000 person-years. At the end of follow-up, the prevalence of MI in the age groups 45-54, 55-64 and >65 years was 1.9%, 6.0% and 27.3% and of angina was 2.6%, 6.0% and 27.3%, respectively. Age-group-specific odds ratios for the prevalence of MI and angina compared to the local female population ranged between 2.6 (95% CI: 1.0-6.3) and 12.9 (CI: 3.4-48.6) with the highest ratio being for MI in the group >65 years old. Age, history of hypertension and smoking had significant correlations with CV outcomes in the PCOS patients.

Conclusion: We have shown a high incidence and age-group-specific prevalence of T2DM, MI and angina in the women with PCOS, with over a quarter having had MI or angina in those >65 years. These findings should be considered in the treatment strategies and long-term planning for women with PCOS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Angina Pectoris / epidemiology
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Female
  • Heart Failure / epidemiology
  • Humans
  • Incidence
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Polycystic Ovary Syndrome / complications*
  • Polycystic Ovary Syndrome / epidemiology
  • Prevalence
  • Retrospective Studies
  • Stroke / epidemiology
  • United Kingdom / epidemiology