PCOS is linked to cardiac function in later life

  • BMJ Open

  • Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • PCOS is associated with changes in cardiac function in later life.

Why this matters

  • Cardiac autonomic dysfunction is associated with depression, anxiety, hypertension, diabetes, cardiovascular diseases, and mortality.

Key results

  • Women with PCOS had reduced vagal activity compared with controls:
    • Higher beats per minute (P=.046),
    • Lower root mean square of successive R-R differences (P=.004),
    • Lower low-frequency power (P=.044),
    • Lower high-frequency power (P=.002), and
    • Lower baroreflex sensitivity (P=.036).
  • Reduced vagal activity was associated with metabolic abnormalities (mean arterial pressure, Homeostasis Model Assessment–insulin resistance [HOMA-IR], triglycerides).
  • Overweight women had more pronounced changes in heart rate variability (HRV) parameters.

Study design

  • Prospective birth cohort study.
  • Cohort identified from the Northern Finland Birth Cohort 1966, a study of women born in 1966 and followed through age 46 years.
  • HRV was compared in women with PCOS symptoms (n=160) and controls (n=1029). 
  • Primary outcome measure was HRV parameters using a heart rate monitor and ECG at rest, sitting, and standing.
  • Funding: Finnish Medical Foundation; North Ostrobothnia Regional Fund; Academy of Finland; Center of Excellence in Complex Disease Genetics; SALVE; University of Oulu; National Institute for Health Research; Medical Research Council UK; and multiple other awards, projects, and foundations.

Limitations

  • Only white women were included.