Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
Diabetes and Vascular Medicine Unit, Monash Health, Clayton, Victoria, Australia.
J Clin Endocrinol Metab. 2021 May 13;106(6):1585-1593. doi: 10.1210/clinem/dgab134.
There are limited studies in large population-based settings examining the relationship between polycystic ovary syndrome (PCOS) and hypertension.
To evaluate incidence of hypertension among women with and without PCOS over a 15-year period.
Secondary analysis of longitudinal data from the Australian Longitudinal Study on Women's Health.
General community.
Women were randomly selected from the national health insurance database. 9508 women, aged 21-42 years, were followed up from 2000 to 2015.
We conducted survival analysis using Cox proportional hazards model to identify predictors of hypertension and person-time analysis to calculate incidence rates of hypertension.
9508 women were followed for 145 159 person years (PY), and 1556 (16.37%) women developed hypertension during follow-up. The incidence of hypertension was significantly higher (P = 0.001) among women with PCOS (17/1000 PY) compared to women without (10/1000 PY). Women with known PCOS status totaled 8223, of which 681 women (8.3%) had self-reported physician-diagnosed PCOS. Incidence rate difference of hypertension (cases attributable to PCOS) was 4-fold higher (15.8/1000 PY vs 4.3/1000 PY) among obese women with PCOS compared to age-matched lean women with PCOS. PCOS was independently associated with 37% greater risk of hypertension (hazard ratio 1.37, 95% confidence interval 1.14-1.65), adjusting for body mass index (BMI), family history of hypertension, occupation, and comorbidity with type 2 diabetes.
Women with PCOS are more likely to develop hypertension from early adulthood, independent of BMI, which is further exacerbated by obesity. Including PCOS in hypertension risk stratification assessments may aid efforts in early identification of the disorder.
在基于大人群的研究中，关于多囊卵巢综合征（PCOS）与高血压之间的关系的研究有限。
评估在 15 年内患有和不患有 PCOS 的女性中高血压的发病率。
对澳大利亚女性健康纵向研究的纵向数据进行二次分析。
一般社区。
从国家健康保险数据库中随机选择女性。9508 名年龄在 21-42 岁的女性从 2000 年随访至 2015 年。
我们使用 Cox 比例风险模型进行生存分析，以确定高血压的预测因素，并进行个体时间分析以计算高血压的发病率。
9508 名女性随访了 145159 人年（PY），1556 名（16.37%）女性在随访期间患上了高血压。患有 PCOS 的女性高血压发病率明显更高（P=0.001）（17/1000 PY），而无 PCOS 的女性为（10/1000 PY）。患有已知 PCOS 状态的女性总计 8223 名，其中 681 名（8.3%）女性有自我报告的医生诊断的 PCOS。与年龄匹配的瘦 PCOS 女性相比，肥胖的 PCOS 女性高血压的发病率差异（归因于 PCOS 的病例）高出 4 倍（15.8/1000 PY 比 4.3/1000 PY）。调整体重指数（BMI）、高血压家族史、职业和 2 型糖尿病合并症后，PCOS 与高血压风险增加 37%独立相关（风险比 1.37，95%置信区间 1.14-1.65）。
患有 PCOS 的女性从成年早期开始更有可能患上高血压，这与 BMI 无关，而肥胖症则进一步加剧了这种情况。将 PCOS 纳入高血压风险分层评估中可能有助于早期发现该疾病。
