Hypertension in Polycystic Ovary Syndrome: Novel Insights

(E-pub Ahead of Print)

Author(s): Djuro Macut* , Violeta Mladenović , Jelica Bjekić-Macut , Sarantis Livadas , Olivera Stanojlović , Dragan Hrnčić , Aleksandra Rašić-Marković , Danijela Vojnović Milutinović , Zoran Andrić .

Journal Name: Current Hypertension Reviews

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Abstract:

Polycystic ovary syndrome (PCOS) is common endocrine disease in women during reproductive age. It was shown that PCOS women are with high risk for dyslipidemia, glucose intolerance, type 2 diabetes and metabolic syndrome. These factors are considered to represent traditional risk factors for the occurrence of cardiovascular disease. Observed increased risk for hypertension in PCOS women seems was associated with insulin resistance and hyperinsulinemia. Both conditions are interfering with the endothelium-dependent vasodilatation mechanisms causing vascular muscle wall hypertrophy. Obesity and insulin resistance are considered key factors for the alteration of blood pressure in PCOS women. Higher cardiovascular risk was implicated in PCOS with aging and its consequent association with both systolic and diastolic blood pressure. The elements of renin–angiotensin–aldosterone system (RAAS) have an impact on endothelial dysfunction as a marker of cardiovascular damage that could be modified is women with PCOS. Androgens and components of RAAS are involved in the process of atherogenesis in PCOS women. Therefore, it is hypothesized that spironolactone treatment could ameliorate endothelial dysfunction in PCOS women. Recently it was shown that telmisartan, angiotensin II receptor antagonist poses insulin-sensitizing capacity to activate PPAR gamma and mediate favorable metabolic and reproductive effects in hypertensive PCOS women.

Keywords: polycystic ovary syndrome, hypertension, obesity, insulin resistance, RAAS.

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(E-pub Ahead of Print)
DOI: 10.2174/1573402115666190531071422

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