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Ovarian Disorder May Hike Heart Disease Risk

Study ties polycystic ovary syndrome with stiff arteries

MONDAY, June 17, 2002 (HealthDayNews) -- New evidence suggests a common gynecological disorder may also spell trouble for a woman's arteries.

After comparing the arteries of healthy women to those with polycystic ovary syndrome (PCOS), British researchers found women with PCOS have stiffer arteries than those without the disorder. Stiff arteries are often an indication of plaque buildup in the arteries, which is a known cause of heart disease.

Results of the study appear in the July 2 issue of Circulation.

"It's already known that women with PCOS have other risk factors for cardiovascular disease like higher cholesterol, a tendency towards overweight, central obesity and slightly higher blood pressure," explains study author Dr. Paul Hardiman, a senior lecturer in obstetrics and gynecology at Royal Free and University College Medical School in London. "This study is a little bit more direct evidence that the blood vessels are being affected by PCOS."

However, he says, that doesn't necessarily mean women with PCOS are destined to have heart attacks. Rather, it shows that they appear to be at an increased risk for heart disease.

"We don't know if these risk factors will translate to the disease itself. Women with PCOS may have some other protective effects that keep them from dying of cardiovascular disease," Hardiman adds.

PCOS is one of the most common endocrine system disorders; Hardiman says as many as 10 percent have it. Researchers still don't know what causes the condition, though insulin resistance appears to play a key role in the development of the disease, he says. Symptoms of PCOS include irregular menstrual cycles, infertility, obesity, and excess body and facial hair.

Previous studies have estimated that women with PCOS may have as high as a seven times greater risk of heart disease than healthy women. Cardiovascular disease, incidentally, is the leading cause of death in women, killing more than 500,000 a year. Some 20 percent of all women have some form of cardiovascular disease, according to the American Heart Association.

In the current study, Hardiman and his team recruited 60 women from London. Twenty had PCOS, 20 had polycystic ovaries but no symptoms of PCOS, and 20 had normal ovaries.

Using a special ultrasound, the researchers were able to measure how 'stretchy' the carotid arteries in the neck were.

They found that women with PCOS had the least stretchy arteries of all three groups. Their arteries were almost twice as stiff as the group with normal ovaries. The group with polycystic ovaries but no symptoms of the syndrome fell in between.

Hardiman says the scientists controlled the data for factors that could affect the results, like high blood pressure or obesity. However, he says, the differences still persisted.

"The evidence is mounting that [women with PCOS] may be at an increased risk for heart disease," says Dr. Noel Bairey Merz, a cardiologist and director of the Women's Health Program at Cedars-Sinai Medical Center in Los Angeles. However, she also cautions it's too soon to know if women with PCOS will actually go on to develop heart disease, or if they are just at an increased risk.

In the meantime, she says, women with PCOS "should be doing the prudent things we recommend to all women -- don't smoke, move for about 30 minutes a day, eat prudently by getting at least five fruits and vegetables a day, and avoiding saturated fats and sweets."

Hardiman says one of the best things someone with PCOS can do is to lose weight, though he acknowledges it may be more difficult to do so because of the disorder. He says it's important because the degree of insulin resistance is directly related to the amount of obesity, and he believes the insulin resistance may be what's causing the cardiovascular changes.

"The reality is there are alterations in metabolism, so it may be harder for women with PCOS to lose weight, but it is even more important for them to do it," he says.

What To Do

For more information on PCOS, go to Women's Health U.K. or to the National Women's Health Information Center from the U.S. Department of Health and Human Services. Click on the American Heart Association to learn more about women and heart disease.

SOURCES: Paul Hardiman, M.D., senior lecturer, obstetrics and gynecology, Royal Free and University College Medical School, London; Noel Bairey Merz, M.D., cardiologist, and director, Women's Health Program, Cedars-Sinai Medical Center, Los Angeles; July 2, 2002, Circulation
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