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Meta-Analysis
. 2020 Mar 17;18(1):23.
doi: 10.1186/s12958-020-00576-1.

Risk of hypertension in women with polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression

Mina Amiri  1 , Fahimeh Ramezani Tehrani  2 , Samira Behboudi-Gandevani  3 , Razieh Bidhendi-Yarandi  1   4 , Enrico Carmina  5
Affiliations
Meta-Analysis

Risk of hypertension in women with polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression

Mina Amiri et al. Reprod Biol Endocrinol. .

Abstract

Background: A limited number of publications have assessed the prevalence of hypertension (HTN) in polycystic ovary syndrome (PCOS) patients with inconclusive results. Since in general populations the occurrence of hypertension is related to age per se, we investigated the prevalence (P) / relative risk (RR) of HTN in pooled patients with PCOS, vs control population among reproductive age women with PCOS, compared to menopause/aging patients.

Methods: PubMed, Scopus, ScienceDirect, web of science, and Google scholar were systematically searched for retrieving observational studies published from inception to April 2019 investigating the HTN in patients with PCOS. The primary outcome of interest was pooled P and RR of HTN in reproductive and menopausal/aging women with PCOS compared to control population.

Results: The pooled prevalence of HTN in reproductive and menopausal/aging women with PCOS was higher than in the control population [(Pooled P: 0.15, 95% CI: 0.12-0.18 vs. Pooled P: 0.09, 95% CI: 0.08-0.10) and (Pooled P: 0.49, 95% CI: 0.28-0.70 vs. Pooled P: 0.40, 95% CI: 0.22-0.57), respectively]. Compared to the control population, pooled relative risk (RR) of HTN patients was increased only in reproductive age PCOS (1.70-fold, 95% CI: 1.43-2.07) but not in menopausal/aging patients who had PCOS during their reproductive years. The same results were obtained for subgroups of population-based studies. Meta-regression analysis of population-based studies showed that the RR of HTN in reproductive age PCOS patients was 1.76-fold than menopausal/aging PCOS patients (P = 0.262).

Conclusion: This meta-analysis confirms a greater risk of HTN in PCOS patients but demonstrates that this risk is increased only in reproductive age women with PCOS, indicating that after menopause, having a history of PCOS may not be as an important predisposing factor for developing HTN.

Keywords: Hypertension; Meta-analysis; Polycystic ovary syndrome; Relative risk.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of search strategy and study selection
Fig. 2
Fig. 2
Forest plot of pooled relative risk of hypertension. Relative risk < 1 shows measures of in favor of PCOS (left side) and relative risk values > 1 are in favor of control population (right side)
Fig. 3
Fig. 3
Forest plot of pooled relative risk of hypertension for population based studies. Relative risk < 1 shows measures of in favor of PCOS (left side) and relative risk values > 1 are in favor of control population (right side)
Fig. 4
Fig. 4
Forest plot of pooled relative risk of hypertension for non-population based studies. Relative risk < 1 shows measures of in favor of PCOS (left side) and relative risk values > 1 are in favor of control population (right side)
Fig. 5
Fig. 5
Bubble plot of association between relative risk of hypertension and age group (a total studies, b population-based studies, c non-population based studies). The solid black line represents the weighted regression line based on variance-weighted least squares. The circles indicate RRs in each study. The circle size is proportional to the precision of the RR. The vertical axis is on a log scale
See this image and copyright information in PMC

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