Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: a systematic review and meta-analysis
Abstract Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder among women of reproductive age and has been associated with increased risks of hypertension (HTN), stroke, and cardiovascular disease (CVD). However, the magnitude and consistency of these associations remain unc...
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2025-08-01
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| Online Access: | https://doi.org/10.1186/s12905-025-03927-5 |
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| author | Bita Pourahmad Mostafa Majidnia Nadia Saniee Sevda Riyahifar Yousef Moradi |
| author_facet | Bita Pourahmad Mostafa Majidnia Nadia Saniee Sevda Riyahifar Yousef Moradi |
| author_sort | Bita Pourahmad |
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| description | Abstract Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder among women of reproductive age and has been associated with increased risks of hypertension (HTN), stroke, and cardiovascular disease (CVD). However, the magnitude and consistency of these associations remain unclear due to varying diagnostic criteria, study designs, and population characteristics. Objective To systematically review and meta-analyze observational studies evaluating the association between PCOS and the risks of hypertension, stroke, and CVD. Methods A systematic literature search was conducted across PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL for studies published between January 1, 1990, and January 1, 2025. Eligible studies included cohort, case–control, and cross-sectional designs comparing women with and without PCOS, as defined by established criteria (Rotterdam, NIH, AES, etc.). Data extraction and quality assessment were performed using standardized checklists and the Newcastle–Ottawa Scale. Relative risks (RR) and 95% confidence intervals (CI) were pooled using a random-effects model. Results A total of 33 studies on hypertension, 10 on stroke, and 26 on CVD were included. Women with PCOS had significantly increased risk of hypertension (pooled RR: 1.45; 95% CI: 1.32–1.61, I2: 82.20%), stroke (pooled RR: 1.28; 95% CI: 1.10–1.49, I2: 54.09%), and cardiovascular disease (pooled RR: 1.41; 95% CI: 1.17–1.71, I2: 97.05%). The risk of hypertension was most pronounced in cohort studies (RR: 1.47; 95% CI: 1.23–1.76) and in European populations (RR: 1.74; 95% CI: 1.40–2.16). PCOS was also associated with elevated risks of stroke and CVD, independent of body mass index (BMI). Heterogeneity across studies was moderate to high, and no significant publication bias was detected. Conclusion PCOS may be linked to an increased risk of hypertension, stroke, and CVD across populations and independent of BMI. Given the high heterogeneity among included studies, these findings should be interpreted with caution. These findings highlight the importance of comprehensive cardiovascular risk assessment and management in women with PCOS. More well-designed, large-scale prospective studies are needed to clarify the underlying mechanisms and improve risk stratification. |
| format | Article |
| id | doaj-art-26fcfc5b403e4ea9924bebef4f65a738 |
| institution | Kabale University |
| issn | 1472-6874 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj-art-26fcfc5b403e4ea9924bebef4f65a7382025-08-20T03:46:12ZengBMCBMC Women's Health1472-68742025-08-0125112310.1186/s12905-025-03927-5Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: a systematic review and meta-analysisBita Pourahmad0Mostafa Majidnia1Nadia Saniee2Sevda Riyahifar3Yousef Moradi4Department of Nursing and Midwifery, Sa.C, Islamic Azad UniversityDepartment of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical SciencesDepartment of Medical Library and Information Sciences, School of Allied Medical Sciences, Hamedan University of Medical SciencesNon-communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical SciencesSocial Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical SciencesAbstract Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder among women of reproductive age and has been associated with increased risks of hypertension (HTN), stroke, and cardiovascular disease (CVD). However, the magnitude and consistency of these associations remain unclear due to varying diagnostic criteria, study designs, and population characteristics. Objective To systematically review and meta-analyze observational studies evaluating the association between PCOS and the risks of hypertension, stroke, and CVD. Methods A systematic literature search was conducted across PubMed, Scopus, Web of Science, Embase, and Cochrane CENTRAL for studies published between January 1, 1990, and January 1, 2025. Eligible studies included cohort, case–control, and cross-sectional designs comparing women with and without PCOS, as defined by established criteria (Rotterdam, NIH, AES, etc.). Data extraction and quality assessment were performed using standardized checklists and the Newcastle–Ottawa Scale. Relative risks (RR) and 95% confidence intervals (CI) were pooled using a random-effects model. Results A total of 33 studies on hypertension, 10 on stroke, and 26 on CVD were included. Women with PCOS had significantly increased risk of hypertension (pooled RR: 1.45; 95% CI: 1.32–1.61, I2: 82.20%), stroke (pooled RR: 1.28; 95% CI: 1.10–1.49, I2: 54.09%), and cardiovascular disease (pooled RR: 1.41; 95% CI: 1.17–1.71, I2: 97.05%). The risk of hypertension was most pronounced in cohort studies (RR: 1.47; 95% CI: 1.23–1.76) and in European populations (RR: 1.74; 95% CI: 1.40–2.16). PCOS was also associated with elevated risks of stroke and CVD, independent of body mass index (BMI). Heterogeneity across studies was moderate to high, and no significant publication bias was detected. Conclusion PCOS may be linked to an increased risk of hypertension, stroke, and CVD across populations and independent of BMI. Given the high heterogeneity among included studies, these findings should be interpreted with caution. These findings highlight the importance of comprehensive cardiovascular risk assessment and management in women with PCOS. More well-designed, large-scale prospective studies are needed to clarify the underlying mechanisms and improve risk stratification.https://doi.org/10.1186/s12905-025-03927-5Polycystic ovary syndromeHypertensionStrokeCardiovascular diseaseMeta-analysis |
| spellingShingle | Bita Pourahmad Mostafa Majidnia Nadia Saniee Sevda Riyahifar Yousef Moradi Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: a systematic review and meta-analysis BMC Women's Health Polycystic ovary syndrome Hypertension Stroke Cardiovascular disease Meta-analysis |
| title | Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: a systematic review and meta-analysis |
| title_full | Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: a systematic review and meta-analysis |
| title_fullStr | Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: a systematic review and meta-analysis |
| title_full_unstemmed | Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: a systematic review and meta-analysis |
| title_short | Polycystic ovary syndrome with stroke, hypertension, and cardiovascular diseases: a systematic review and meta-analysis |
| title_sort | polycystic ovary syndrome with stroke hypertension and cardiovascular diseases a systematic review and meta analysis |
| topic | Polycystic ovary syndrome Hypertension Stroke Cardiovascular disease Meta-analysis |
| url | https://doi.org/10.1186/s12905-025-03927-5 |
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