The Connection Between PCOS and Heart Disease

Heart disease is the leading cause of death in this country, even higher than cancer. Polycystic ovary syndrome (PCOS) is linked to a risk of heart disease, especially among women who are premenopausal.

Several common factors increase the risk of heart disease, including smoking, high blood pressure, obesity, unhealthy diet, sedentary lifestyle, diabetes, and increased alcohol intake. If you have PCOS, it's especially important that you pay attention to the medical and lifestyle issues that lead to heart disease so you can lower your risk of developing this disease—which can interfere with your quality of life and cause life-threatening complications.

Woman having her blood pressure tested
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Cardiovascular Risk Factors in PCOS

Metabolic syndrome is associated with PCOS and it is one of the contributors to the increased rate of cardiovascular disease among people who have PCOS. Cardiovascular disease is a disease of the blood vessels in the heart—it leads to heart failure, heart attacks, and strokes.

Metabolic syndrome is a condition characterized by high body mass index (BMI), hypertension (chronically elevated blood pressure), insulin resistance, and unhealthy fat and cholesterol levels.

Most people who have metabolic syndrome have elevated triglycerides, low levels of heart-healthy high-density lipoprotein (HDL) cholesterol, and high levels of unhealthy low-density lipoprotein (LDL) cholesterol.

Hypertension

Hypertension is a silent condition, which is why many people don’t even know if they have it.

Blood pressure is a measure of the force of the blood moving through the blood vessels. When it's too high, it is an indication that the heart has to pump harder to circulate blood to the body. This can be caused by atherosclerosis, which is the hardening of the blood vessel walls.

High blood pressure can be idiopathic (without a known cause), and lifestyle factors such as smoking, an unhealthy diet, and a sedentary lifestyle can contribute to hypertension. It can be treated with lifestyle changes and medication.

Abnormal Cholesterol Levels

Cholesterol is made in our own bodies and influenced by what we eat every day. Having PCOS can put you at risk for elevated cholesterol and elevated triglyceride levels and low levels of HDL.

Unhealthy cholesterol levels contribute to atherosclerosis.

Atherosclerosis

Atherosclerosis is the build-up of hard, fatty plaques in the arteries. Hypertension, diabetes, and unhealthy cholesterol levels all contribute to atherosclerosis. The condition can damage the blood vessels and impede normal blood flow throughout the body. It can also lead to blood clots.

Atherosclerosis in the coronary arteries, which are the arteries that supply the heart muscle, can cause heart attacks and heart failure. Atherosclerosis in the carotid arteries or the arteries in the brain can lead to strokes.

High blood pressure, high blood sugar, unhealthy cholesterol, obesity, and atherosclerosis are all features of metabolic syndrome, and they all contribute to each other.

Reducing the Risk

If you have PCOS, it's important for you to know that you could be at an increased risk of developing heart disease at an early age. So what can you do to reduce the risk of developing cardiovascular disease when you have PCOS? The first step is to have your weight, blood pressure, blood sugar, and cholesterol checked routinely and to talk to your doctor about your risk factors.

Things you can do:

  • Stop smoking if you smoke.
  • Maintain a healthy weight through diet and exercise.
  • Avoid excess saturated fat in your diet, even if you are at a healthy weight.
  • Avoid excess salt in your diet.

Sources of saturated fat typically include animal products such as red meat, butter, and processed meats (which are also high in salt). Replace saturated fat with healthier unsaturated sources of fat such as olive oil, nuts, seeds, and avocados.

Eating a diet rich in fruits and vegetables, which contain fiber and antioxidants, can help you to lower your blood pressure and avoid gaining excess weight.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Leading causes of death.

  2. Ramezani Tehrani F, Amiri M, Behboudi-Gandevani S, Bidhendi-Yarandi R, Carmina E. Cardiovascular events among reproductive and menopausal age women with polycystic ovary syndrome: a systematic review and meta-analysis. Gynecol Endocrinol. 2020 Jan;36(1):12-23. doi:10.1080/09513590.2019.1650337

  3. Berni TR, Morgan CL, Rees DA. Women with polycystic ovary syndrome have an increased risk of major cardiovascular events: A population study. J Clin Endocrinol Metab. 2021 Aug 18;106(9):e3369-e3380. doi:10.1210/clinem/dgab392

  4. Zhao X, Feng X, Zhao X, Jiang Y, Li X, Niu J, Meng X, Wu J, Xu G, Hou L, Wang Y. How to screen and prevent metabolic syndrome in patients of PCOS early: Implications from metabolomics. Front Endocrinol (Lausanne). 2021 Jun 2;12:659268. doi:10.3389/fendo.2021.659268

Additional Reading
  • Baldani DP, Skrgatic L, Ougouag R.Polycystic Ovary Syndrome: Important Underrecognised Cardiometabolic Risk Factor in Reproductive-Age Women. Int J Endocrinol. 2015;2015

  • Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (PDF)