Incidence and Predictors of Hypertension in a Cohort of Australian Women With and Without Polycystic Ovary Syndrome

Abstract

Abstract Context There are limited studies in large population-based settings examining the relationship between polycystic ovary syndrome (PCOS) and hypertension. Objective To evaluate incidence of hypertension among women with and without PCOS over a 15-year period. Design Secondary analysis of longitudinal data from the Australian Longitudinal Study on Women’s Health. Setting General community. Participants Women were randomly selected from the national health insurance database. 9508 women, aged 21-42 years, were followed up from 2000 to 2015. Methods We conducted survival analysis using Cox proportional hazards model to identify predictors of hypertension and person-time analysis to calculate incidence rates of hypertension. Results 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. Conclusions 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.