PMOS linked to four-fold heart disease risk rise

A diagnosis of polyendocrine metabolic ovarian syndrome (PMOS) has been linked to a four-fold increased risk of heart disease in women, leading experts to urge GPs to conduct early screening.
 
The findings of a new study, published in The Lancet Obstetrics, Gynaecology, & Women’s Health, follow an analysis of more than 2.4 million women in the United States.
 
Researchers investigated the cohort’s health insurance data over a 22-year period, which included around 413,000 PMOS patients aged 18–50.
 
They concluded that women with the condition, formally known as polycystic ovary syndrome (PCOS), have a ‘significantly higher’ incidence of atherosclerotic cardiovascular disease events.
 
This increased risk remained even after accounting for obesity and other heart disease risk factors, such as high blood pressure, high cholesterol, and diabetes, ‘suggesting that other biological factors related to PMOS may contribute to heart disease’.
 
The study’s authors say their analysis underscores the importance of healthcare professionals offering early heart health screening for people with PMOS, as well as promoting prevention measures such as weight management, healthy eating, and regular physical activity.
 
‘Our findings highlight the need for healthcare provider and patient education and awareness to improve early screening, counselling, and long-term surveillance in this population,’ they concluded.
 
‘Because risk is not solely attributable to cardiovascular disease risk factors, the association should also be discussed in patients without traditional risk factors, such as hypertension, type 2 diabetes, infertility, and obesity.’
 
Dr Anuja Dokras, the study’s senior author, said it is ‘imperative’ clinicians closely track and evaluate cardiovascular health in patients with PMOS.
 
‘It is also important for all individuals with PMOS to care for their heart health and control other factors that can lead to poor cardiovascular health, including smoking, inactivity, obesity, high LDL cholesterol, diabetes, and high blood pressure,’ she said.
 
Associate Professor Magdalena Simonis, a Melbourne GP with a special interest in women’s health, said while she is not shocked by the research, it is surprising that it has been ‘such a long time coming’.
 
‘One in eight women suffer from PMOS and to date, the thinking has been that by commencing patients on the pill, they’d be okay,’ she told newsGP.
 
‘What this suggests however, is that PMOS is associated with long-term consequences that can impact life quality, cause significant morbidity and shorten life span. We need to think beyond just regulating periods, addressing hirsutism, acne and mood changes. 
 
‘We need to identify and manage PMOS from as early as possible and not take a “set and forget” approach, which means that review is needed here with monitoring and support of lifestyle interventions such as healthy eating, exercise and weight loss, where weight is a problem.’
 
Associate Professor Simonis said this requires ‘re-education of the community and the health sector’ to acknowledge that this is a long-term metabolic dysfunction which persists throughout life.
 
Moving forward, researchers said that, given the most recent study only includes a young premenopausal population, future longitudinal studies should determine progression through menopause.
 
Associate Professor Simonis added that PMOS’s recent name change will go a long way in changing views of the condition, but said there is still work to be done.
 
‘Education directed at upskilling GPs needs to be supported by the college and PMOS resources made available for patients to understand that lifestyle management is one of the most effective intervention strategies long term,’ she said.
 
Log in below to join the conversation.

heart disease PCOS PMOS polycystic ovary syndrome polyendocrine metabolic ovarian syndrome