Polycystic ovary syndrome and cardiovascular disease risk

Aim. To define and discuss the main pathogenic mechanisms of polycystic ovary syndrome (PCOS) and its association with cardiometabolic risk factors.
Material and methods. The material for this nonsystematic review was collected from peer-reviewed articles published in PubMed, eLibrary.RU, CyberLeninka, and other research databases from 2006 to 2024 using the following terms: polycystic ovary syndrome, cardiometabolic risk factors, phenotypes, and cardiovascular diseases.
Results. Population studies suggest that the risk of hypertension and cardiovascular diseases is higher in the reproductive age group compared to the general population. An increased risk of cardiovascular diseases in younger individuals (children, adolescents) may be associated with maternal PCOS. The transition to menopause is likely not associated with a deterioration in the cardiometabolic profile, which may be linked to improvements in the phenotypic features of PCOS with age. Cardiometabolic risk varies depending on the PCOS phenotype, which may support a new classification approach to PCOS. Mendelian randomization studies indicate that it is not PCOS itself, but rather the associated factors (obesity, hyperandrogenism), that likely explain the epidemiological link between PCOS and cardiometabolic diseases. According to published international guidelines for the treatment of PCOS, women with PCOS should regularly assess their overall cardiovascular risk in order to individualize therapy.
Conclusion. Women with PCOS are at increased risk for cardiovascular diseases and cardiometabolic disorders compared to the general population. However, the degree of risk may depend on the PCOS phenotype and the stage of life. Further research is needed, including studies in different age groups (adolescents, reproductive age, menopause, postmenopause), to determine the most effective strategies for reducing the cardiovascular disease risk associated with PCOS.

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