Cardiovascular disease risk in women with PCOS

•PCOS women have many CV risk factors (obesity, diabetes, hypertension, dyslipidemia).•Algorithms can assess CV risk and individual risk of CV events in high-risk women.•There is evidence for increased subclinical atherosclerosis in PCOS women.•Few studies show an increased risk for coronary artery disease in PCOS women.

Cardiac disease is the number one killer in women. Adolescents and reproductive age women with PCOS have an increased prevalence of cardiovascular risk factors. These include obesity, impaired glucose tolerance, diabetes, hypertension, mood disorders and metabolic syndrome. There is sufficient evidence to confirm the presence of subclinical atherosclerosis in women with PCOS compared to age matched controls. There are, however, few prospective studies examining non-fatal and fatal cardiac events in women with well-defined PCOS. Future directions of research should include longitudinal studies in peri- and post-menopausal women with prospectively defined PCOS to better estimate the risk of cardiac morbidity and mortality in this high-risk population. In the meantime, regular screening for risk factors and timely early interventions are critical to reduce the overall risk burden.