TOPLINE:

Women with polycystic ovary syndrome (PCOS) from three Nordic countries had a higher risk for cardiovascular disease (CVD) than control women without PCOS. This elevated risk persisted among women with BMI < 25 and without type 2 diabetes.

METHODOLOGY:

• Researchers conducted a large register-based study in three Nordic countries to evaluate the prospective risk for CVD in women with PCOS and to assess whether BMI and type 2 diabetes mediated this risk.
• They included 127,517 women with PCOS and 587,810 control participants from Denmark (median age, 28 years), Finland (median age, 29 years), and Sweden (median age, 29 years), with a median follow-up duration ranging from 8 to 10 years.
• Participants with previous CVD or conditions mimicking PCOS such as acromegaly, Cushing syndrome, adrenogenital syndrome, and Turner syndrome were excluded.
• The primary outcome was CVD, defined as major adverse cardiovascular events (acute myocardial infarction, cerebrovascular disease, CVD death, or heart failure), pulmonary embolism, or deep vein thrombosis.

TAKEAWAY:

• The risk for CVD was higher among women with PCOS from Denmark (adjusted hazard ratio [aHR], 1.21; 95% CI, 1.11-1.31), Finland (aHR, 1.39; 95% CI, 1.25-1.53), and Sweden (aHR, 1.24; 95% CI, 1.18-1.31) than among control women.
• In a combined meta-analysis including all countries, the risk for CVD, pulmonary embolism or deep vein thrombosis, and major adverse cardiovascular events was 27%, 30%, and 21% higher, respectively, among women with PCOS than among control women.
• Moreover, the risk for CVD was 40% higher among women with PCOS who had BMI < 25 and no diagnosis of type 2 diabetes (aHR, 1.40; 95% CI, 1.26-1.55).

IN PRACTICE:

"Our findings support awareness for CVD risk also in young and normal weight women with PCOS," the authors wrote.

SOURCE:

This study was led by Dorte Glintborg, DSc, Department of Endocrinology, Odense University Hospital, Odense, Denmark. It was published online on December 24, 2025, in the European Journal of Endocrinology.

LIMITATIONS:

The prevalence of PCOS was potentially underestimated because this study included only women with PCOS diagnosed in specialist care. More severe cases of PCOS were captured, which could have overestimated the risk for CVD. The inclusion of relatively young individuals (median age, 28-29 years) with a median follow-up duration of 8-10 years may have affected the findings as the risk for CVD increased at higher age and few women were older than 50 years.

DISCLOSURES:

This study received funding from the Region of Southern Denmark, Overlægerådet, Odense University Hospital, and Danish Research Council (Denmark) and Novo Nordisk Foundation, Finnish Research Council, Sigrid Jusélius Foundation, and National Regional Fund (Finland). One author reported receiving a research grant from Ferring Pharmaceuticals and serving as a medical advisor for Tilly AB.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.