(18-06-10) 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.

Wild RA, Carmina E, Diamanti-Kandarakis E, Dokras A, Escobar-Morreale HF,
Futterweit W, Lobo R, Norman RJ, Talbott E, Dumesic DA.

Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma 73104,
USA.
Abstract
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. PARTICIPANTS: An expert panel in PCOS and CVD
reviewed literature and presented recommendations. EVIDENCE: 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. CONSENSUS PROCESS: 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.

Source: J Clin Endocrinol Metab. 2010 May;95(5):2038-49. Epub 2010 Apr 7.

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