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Polycystic ovary syndrome: androgens and hypertension.

Polycystic ovary syndrome (PCOS) is a condition of ovarian dysfunction that affects 6% to 10% of women of reproductive age. The hallmarks of PCOS are menstrual cycle irregularities, androgen excess, and polycystic ovaries, as defined by the Rotterdam Consensus on Diagnostic Criteria for PCOS. Most women also exhibit elevated luteinizing hormone/follicular-stimulating hormone ratios but normal levels of estradiol. In addition, many women with PCOS are obese, and Ehrmann et al1 reported recently that 33.4% of US women with PCOS exhibit symptoms of the metabolic syndrome, such as increased hyperglycemia, insulin resistance, and dyslipidemia, although this percentage varies depending on the cohort studied. Frequently these young women exhibit hypertension as well.

Despite the list of characteristics that typically accompany PCOS, the exact mechanism(s) responsible for hypertension in women with PCOS is controversial. Many of the symptoms associated with PCOS have been shown to also be associated with increases in blood pressure, such as increases in body mass index and the presence of metabolic syndrome, with its accompanying insulin resistance and type 2 diabetes.

Whether androgens contribute to the hypertension in women with PCOS has not been shown previously. In the current issue of Hypertension , Chen et al2 attempt to dissect the role that androgens may play in mediating the hypertension in young women with PCOS. Their studies were performed in a cohort of Taiwanese women, with an average age of 24 years. …