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A study conducted by the Royal Free and University College Medical School in London found that women with PCOS were nearly twice as likely to suffer from atherosclerosis (plaque deposits in the arteries), than women without the syndrome. Atherosclerosis sharply increases the risk of coronary heart disease and stroke."The implication is that a common condition thought to be primarily a gynecological problem may predispose women to heart disease," says lead author Paul Hardiman, M.D., a Senior Lecturer in obstetrics and gynecology.
Coronary heart disease is the largest killer of men and women in the United States, according to the American Heart Association. Previous research has linked PCOS, which is one of the most common causes of infertility in reproductive aged women, with multiple risk factors for coronary heart disease, including Diabetes, obesity and hypertension. Women with PCOS often have elevated cholesterol levels, high blood pressure, obesity and of course, Insulin Resistance, which is the underlying cause of PCOS.
Insulin Resistance increases a person's risk of developing Type 2 Diabetes, and this condition sharply increases the risk of heart disease. Previous research has estimated that these factors can cause up to a seven-fold increase in risk for heart attack for women with PCOS compared to those without it. In the London study, there was no significant difference in age or in total cholesterol, HDL ("good") or LDL ("bad") cholesterol among the groups taking part. However, compared to women with normal ovaries, those with PCOS had significantly higher weight, blood pressure and insulin levels.Researchers have found that PCOS, with its symptomatic disorders of hypertension, excessive fat tissue in and around the abdominal area, blood fat disorders (high triglycerides and low HDL), high blood pressure, Hyperandrogenism (elevated levels of male hormones) and Insulin Resistance, put sufferers at higher risk of developing future serious, life-threatening health conditions such as coronary heart disease and stroke.
Coronary heart disease (CHD) is a broad term that describes any disorder that can impact the functioning of the heart muscle itself or the cardiovascular system. Conditions that contribute to heart disease include: high blood pressure, Cardiovascular Disease, arteriosclerosis (hardening of the arteries), atherosclerosis and more. The causes of heart disease include: elevated LDL cholesterol, low HDL cholesterol, obesity, elevated blood pressure, Diabetes, cigarette smoking and lack of physical activity - many of the underlying conditions found in both PCOS and Insulin Resistance.Chronic high levels of glucose and insulin are classic symptoms of Insulin Resistance and PCOS.
One of the primary risk factors for arteriosclerosis is an elevated level of triglycerides and the biggest risk factor for increasing the production of triglycerides is the rate of your insulin secretion.Insulin is produced in your pancreas and released into the circulatory system where it is the key to the absorption of glucose by your cells. If your cells resist insulin, both insulin and glucose build up in your blood. Excess insulin leads to weight gain and high blood pressure - both precursors to heart disease. As insulin comes in contact with the interior wall of the arteries, it damages the tissue, causing the initial injury that produces plaque. Therefore, having Insulin Resistance and PCOS directly cause changes in the blood lipids and overall cardiovascular health that contribute to the formation of heart disease.
Recommendations for reducing heart disease risk are the same as those for reducing Insulin Resistance: decreasing insulin, balancing cholesterol and lowering blood pressure. It all involves managing PCOS to minimize current symptoms and an attempt to delay or prevent worsening of the underlying conditions that lead to heart disease. This can be done through careful food choices, exercise and weight loss in overweight individuals. But a multi-faceted approach is clearly necessary to address all the symptoms of these conditions.
To learn more about heart health please visit Dr. Sarah Samaan on Twitter @heartsmarter and The AHA Philly @AHAPhilly
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