Dokras A, Luque-Ramírez M, Escobar-Morreale HF. POLYCYSTIC OVARY SYNDROME: ORIGINS AND IMPLICATIONS: Long-term health outcomes in polycystic ovary syndrome. Reproduction. 2025;170(2):e250118. https://doi.org/10.1530/REP-25-0118. PMID: 40555382.
Yang H, Xiao ZY, Yin ZH, Yu Z, Liu JJ, Xiao YQ, et al. Efficacy and safety of acupuncture for polycystic ovary syndrome: an overview of systematic reviews. J Integr Med. 2023;21(2):136–48.
Google Scholar
Luan YY, Zhang L, Peng YQ, Li YY, Liu RX, Yin CH. Immune regulation in polycystic ovary syndrome. Clin Chim Acta. 2022;531:265–72.
Google Scholar
Waghmare SV, Shanoo A. Polycystic ovary syndrome: a literature review with a focus on diagnosis, pathophysiology, and management. Cureus. 2023;15(10):e47408.
Google Scholar
Weng L, Zhu Q, Xiang Y, Cao T, Cai J, Liang N, et al. METTL3-mediated m(6)A modification of CD36: Implications for glucose metabolism and inflammatory dysregulation in follicles of polycystic ovary syndrome. Int Immunopharmacol. 2024;143(Pt 1): 113327.
Google Scholar
Xu Y, Qiao J. Association of insulin resistance and elevated androgen levels with Polycystic Ovarian Syndrome (PCOS): A Review of Literature. J Healthc Eng. 2022;2022:9240569.
Google Scholar
Briceño Silva GD, Thomas Garcia KD, Ajamyan H, Shekhawat P, Rodriguez LC, Hammoud A, et al. Polycystic ovarian syndrome: exploring hypertension and cardiometabolic implications. Cureus. 2024;16(10): e70958.
Google Scholar
Mohamed AH, Albasheer O, Ghoniem MA, Abdalghani N, Ayish F, Abdelwahab SI, et al. Impact of lifestyle interventions on reproductive and psychological outcomes in women with polycystic ovary syndrome: a systematic review. Medicine (Baltimore). 2025;104(3): e41178.
Google Scholar
Salari N, Nankali A, Ghanbari A, Jafarpour S, Ghasemi H, Dokaneheifard S, et al. Global prevalence of polycystic ovary syndrome in women worldwide: a comprehensive systematic review and meta-analysis. Arch Gynecol Obstet. 2024;310(3):1303–14.
Google Scholar
Chiaffarino F, Cipriani S, Dalmartello M, Ricci E, Esposito G, Fedele F, et al. Prevalence of polycystic ovary syndrome in European countries and USA: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2022;279:159–70.
Google Scholar
Deswal R, Narwal V, Dang A, Pundir CS. The prevalence of polycystic ovary syndrome: a brief systematic review. J Hum Reprod Sci. 2020;13(4):261–71.
Google Scholar
Farhadi-Azar M, Behboudi-Gandevani S, Rahmati M, Mahboobifard F, Khalili Pouya E, Ramezani Tehrani F, et al. The prevalence of polycystic ovary syndrome, its phenotypes and cardio-metabolic features in a community sample of Iranian population: Tehran lipid and glucose study. Front Endocrinol (Lausanne). 2022;13: 825528.
Google Scholar
Joham AE, Kakoly NS, Teede HJ, Earnest A. Incidence and predictors of hypertension in a cohort of Australian women with and without polycystic ovary syndrome. J Clin Endocrinol Metab. 2021;106(6):1585–93.
Google Scholar
Guzik TJ, Nosalski R, Maffia P, Drummond GR. Immune and inflammatory mechanisms in hypertension. Nat Rev Cardiol. 2024;21(6):396–416.
Google Scholar
Charchar FJ, Prestes PR, Mills C, Ching SM, Neupane D, Marques FZ, et al. Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension. J Hypertens. 2024;42(1):23–49.
Google Scholar
Goorani S, Zangene S, Imig JD. Hypertension: A Continuing Public Healthcare Issue. Int J Mol Sci. 2024;26(1):123. https://doi.org/10.3390/ijms26010123. PMID: 39795981; PMCID: PMC11720251.
Tasić T, Tadić M, Lozić M. Hypertension in women. Front Cardiovasc Med. 2022;9: 905504.
Google Scholar
Braekman E, De Bruyne R, Vandekerckhove K, Prytula A. Etiology, risk factors and management of hypertension post liver transplantation. Pediatr Transplant. 2024;28(1): e14630.
Google Scholar
Macut D, Mladenović V, Bjekić-Macut J, Livadas S, Stanojlović O, Hrnčić D, et al. Hypertension in polycystic ovary syndrome: novel insights. Curr Hypertens Rev. 2020;16(1):55–60.
Google Scholar
Ibrahim S, Bielecki J, Kocabas E, Singh S, Senff JR, Casaubon LK, et al. Lifestyle approaches to hypertension for prevention of stroke and vascular cognitive impairment: a realist review protocol. BMJ Open. 2024;14(9): e088631.
Google Scholar
Hilkens NA, Casolla B, Leung TW, de Leeuw FE. Stroke. Lancet. 2024;403(10446):2820–36.
Google Scholar
Neil HP. Stroke rehabilitation. Crit Care Nurs Clin North Am. 2023;35(1):95–9.
Google Scholar
Tan KS, Pandian JD, Liu L, Toyoda K, Leung TWH, Uchiyama S, et al. Stroke in Asia. Cerebrovasc Dis Extra. 2024;14(1):58–75.
Google Scholar
Shafaat O, Sotoudeh H. Stroke Imaging. [Updated 2023 May 1]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546635/.
Qin C, Yang S, Chu YH, Zhang H, Pang XW, Chen L, et al. Signaling pathways involved in ischemic stroke: molecular mechanisms and therapeutic interventions. Signal Transduct Target Ther. 2022;7(1):215.
Google Scholar
Pham TTM, Duong TV, Nguyen LTK, Vu MT, Pham KM, Nguyen MH, et al. Association between hypertension and stroke recurrence as modified by pro-oxidant-antioxidant balance: a multi-center study. Nutrients. 2023. https://doi.org/10.3390/nu15102305.
Google Scholar
Feigin VL, Brainin M, Norrving B, Martins SO, Pandian J, Lindsay P, et al. World Stroke Organization: global stroke fact sheet 2025. Int J Stroke. 2024;20:17474930241308142.
Lalo R, Zekja I, Kamberi F. Association of cardiovascular disease risk and health-related behaviors in stroke patients. Int J Environ Res Public Health. 2023. https://doi.org/10.3390/ijerph20043693.
Google Scholar
Cherian T, Morales KF, Mantel CF, Lambach P, Al Awaidy S, Bresee JS, et al. Factors and considerations for establishing and improving seasonal influenza vaccination of health workers: report from a WHO meeting, January 16–17, Berlin, Germany. Vaccine. 2019;37:6255–61.
Google Scholar
World Health Organization (WHO). Cardiovascular diseases (2019). 2019. Available from: https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1.
Olié V, Gabet A, Grave C, Helft G, Fosse-Edorh S, Piffaretti C, et al. Epidemiology of cardiovascular risk factors: non-behavioural risk factors. Arch Cardiovasc Dis. 2024;117(12):761–9.
Google Scholar
Orio F, Muscogiuri G, Nese C, Palomba S, Savastano S, Tafuri D, et al. Obesity, type 2 diabetes mellitus and cardiovascular disease risk: an uptodate in the management of polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2016;207:214–9.
Google Scholar
Özkan S, Yılmaz Ö, Yavuz B. Increased masked hypertension prevalence in patients with polycystic ovary syndrome (PCOS). Clin Exp Hypertens. 2020;42(8):681–4.
Google Scholar
Mellembakken JR, Mahmoudan A, Mørkrid L, Sundström-Poromaa I, Morin-Papunen L, Tapanainen JS, et al. Higher blood pressure in normal weight women with PCOS compared to controls. Endocr Connect. 2021;10(2):154–63.
Google Scholar
Stewart CE, Sohrabji F. Gonadal hormones and stroke risk: PCOS as a case study. Front Neuroendocrinol. 2020;58: 100853.
Google Scholar
Young women with polycystic ovary syndrome have raised risk of heart disease 2020. Available from: https://www.escardio.org/The-ESC/Press-Office/Press-releases/Young-women-with-polycystic-ovary-syndrome-have-raised-risk-of-heart-disease.
Fuchs FD, Whelton PK. High blood pressure and cardiovascular disease. Hypertension. 2020;75(2):285–92.
Google Scholar
Profili NI, Castelli R, Gidaro A, Manetti R, Maioli M, Petrillo M, et al. Possible effect of Polycystic Ovary Syndrome (PCOS) on Cardiovascular Disease (CVD): an update. J Clin Med. 2024;13(3):698.
Google Scholar
Guixue G, Yifu P, Xiaofeng T, Qian S, Yuan G, Wen Y, et al. Investigating the causal impact of polycystic ovary syndrome on gestational diabetes mellitus: a two-sample Mendelian randomization study. Front Endocrinol (Lausanne). 2024;15: 1337562.
Google Scholar
Zhu T, Cui J, Goodarzi MO. Polycystic ovary syndrome and risk of type 2 diabetes, coronary heart disease, and stroke. Diabetes. 2021;70(2):627–37.
Google Scholar
Amiri M, Ramezani Tehrani F, Behboudi-Gandevani S, Bidhendi-Yarandi R, Carmina E. Risk of hypertension in women with polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression. Reprod Biol Endocrinol. 2020;18(1):23.
Google Scholar
Douglas CC, Rojo JU. Population and diagnostic characteristics of polycystic ovary syndrome and hyperandrogenism. Womens Health Rep. 2024;5(1):945–53.
Zhang S, Darbinian JA, Greenspan LC, Naderi S, Ramalingam ND, Lo JC. Hypertensive blood pressure in adolescent females with polycystic ovary syndrome. Am J Prev Med. 2025;68(2):408–11.
Google Scholar
Hayes MG, Urbanek M, Ehrmann DA, Armstrong LL, Lee JY, Sisk R, et al. Genome-wide association of polycystic ovary syndrome implicates alterations in gonadotropin secretion in European ancestry populations. Nat Commun. 2015;6(1):7502.
Google Scholar
Joham AE, Ranasinha S, Zoungas S, Moran L, Teede HJ. Gestational diabetes and type 2 diabetes in reproductive-aged women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2014;99(3):E447–52.
Google Scholar
Dopler B. Stroke prevention. Dela J Public Health. 2023;9(3):6–10.
Google Scholar
Zhou Y, Wang X, Jiang Y, Ma H, Chen L, Lai C, et al. Association between polycystic ovary syndrome and the risk of stroke and all-cause mortality: insights from a meta-analysis. Gynecol Endocrinol. 2017;33(12):904–10.
Google Scholar
Su J, Fan X, Li M, Yu H, Geng H, Qin Y, et al. Association of lifestyle with reduced stroke risk in 41 314 individuals with diabetes: two prospective cohort studies in China. Diabetes Obes Metab. 2024;26(7):2869–80.
Google Scholar
Yonis H, Løkkegaard E, Kragholm K, Granger CB, Møller AL, Mørch LS, et al. Stroke and myocardial infarction with contemporary hormonal contraception: real-world, nationwide, prospective cohort study. BMJ. 2025;388: e082801.
Google Scholar
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;106(9):e3369–80.
Google Scholar
Barić H, Komljenović S, Bilić K, Migo W, Vitowanu JM, Desnica A, et al. Hematologic indices and chronic subdural hematoma: a single-center cohort study. Asian J Neurosurg. 2024;19(4):735–40.
Google Scholar
Dammavalam V, Nolan B, Jain A, Sacknovitz A, Fortunato M, Xu P, et al. Abstract 369: polycystic ovary syndrome as a risk factor for acute ischemic stroke during childbearing years. Stroke Vasc Interv Neurol. 2024;4(S1):e12984_369.
Duică F, Dănilă CA, Boboc AE, Antoniadis P, Condrat CE, Onciul S, et al. Impact of increased oxidative stress on cardiovascular diseases in women with polycystic ovary syndrome. Front Endocrinol. 2021;12: 614679.
Lo AC, Lo CCW, Oliver-Williams C. Cardiovascular disease risk in women with hyperandrogenism, oligomenorrhea/menstrual irregularity or polycystic ovaries (components of polycystic ovary syndrome): a systematic review and meta-analysis. Eur Heart J Open. 2023;3(4): oead061.
Google Scholar
Glintborg D, Rubin KH, Nybo M, Abrahamsen B, Andersen M. Cardiovascular disease in a nationwide population of Danish women with polycystic ovary syndrome. Cardiovasc Diabetol. 2018;17(1):37.
Google Scholar
Meun C, Gunning MN, Louwers YV, Peters H, Roos-Hesselink J, Roeters van Lennep J, et al. The cardiovascular risk profile of middle-aged women with polycystic ovary syndrome. Clin Endocrinol. 2020;92(2):150–8.
Zhu S, Zhang B, Jiang X, Li Z, Zhao S, Cui L, et al. Metabolic disturbances in non-obese women with polycystic ovary syndrome: a systematic review and meta-analysis. Fertil Steril. 2019;111(1):168–77.
Google Scholar
Parveen S, Khan S, Khan MM, Gupta B, Ahmad A, Alam R. Association of lipid profile and obesity in patients with polycystic ovary syndrome. Endocr Regul. 2024;58(1):83–90.
Google Scholar
Saei Ghare Naz M, Mousavi M, Firouzi F, Momenan A, Azizi F, Ramezani Tehrani F. Association between insulin resistance indices and liver function parameters among women with polycystic ovary syndrome. Endocrinology, Diabetes & Metabolism. 2024. https://doi.org/10.1002/edm2.490.
Liao CC, Chien CH, Yu TS, Li JM. Integrated Chinese and Western medicine for coronary heart disease prevention in polycystic ovary syndrome: a 19-year nationwide cohort study. J Multidiscip Healthc. 2023;16:3959–73.
Google Scholar
Juber NF, Abdulle A, Aljunaibi A, Alnaeemi A, Ahmad A, Leinberger-Jabari A, et al. Association between self-reported polycystic ovary syndrome with chronic diseases among emiratis: a cross-sectional analysis from the UAE Healthy Future Study. Int J Womens Health. 2023;15:289–98.
Google Scholar
Aghade S, Deshmukh S, Katre D. Assessment of reproductive health, metabolic and cardiovascular risk profile in first-degree relatives of women with polycystic ovarian syndrome: a hospital-based study in Maharashtra, India. Int J Acad Med Pharm. 2023;5(5):682–7.
Mahalingaiah S, Li H, Scalise A, Gallagher NJ, Gabra M, Onnela JP, et al. Prevalence of cardiovascular disease among women with a clinician diagnosis of polycystic ovary syndrome in a digital longitudinal cohort. Fertil Steril. 2022;118(4):e190.
Forslund M, Landin-Wilhelmsen K, Brännström M, Dahlgren E. No difference in morbidity between perimenopausal women with PCOS with and without previous wedge resection. Eur J Obstet Gynecol Reprod Biol. 2023;285:74–8.
Google Scholar
Forslund M, Schmidt J, Brännström M, Landin-Wilhelmsen K, Dahlgren E. Morbidity and mortality in PCOS: a prospective follow-up up to a mean age above 80 years. Eur J Obstet Gynecol Reprod Biol. 2022;271:195–203.
Google Scholar
Ryu KJ, Kim MS, Kim HK, Kim YJ, Yi KW, Shin JH, et al. Risk of type 2 diabetes is increased in nonobese women with polycystic ovary syndrome: the National Health Insurance Service-National Sample Cohort Study. Fertil Steril. 2021;115(6):1569–75.
Google Scholar
Oliver-Williams C, Vassard D, Pinborg A, Schmidt L. Risk of cardiovascular disease for women with polycystic ovary syndrome: results from a national Danish registry cohort study. Eur J Prev Cardiol. 2021;28(12):E39–41.
Google Scholar
Wu CH, Chiu LT, Chang YJ, Lee CI, Lee MS, Lee TH, et al. Hypertension risk in young women with polycystic ovary syndrome: a nationwide population-based cohort study. Front Med. 2020;7:574651.
Lee TH, Wu CH, Chen ML, Yip HT, Lee CI, Lee MS, et al. Risk of psoriasis in patients with polycystic ovary syndrome: a national population-based cohort study. J Clin Med. 2020;9(6):1–10.
Brouzeng C, Bachelot A, Moriniere C, Vaillant J, Joguet G, Velayoudom FL. Triglycerides as a metabolic target in Afrocaribbean infertile women with polycystic ovary syndrome. Metab Syndr Relat Disord. 2019;17(10):500–4.
Google Scholar
Ding DC, Tsai IJ, Wang JH, Lin SZ, Sung FC. Coronary artery disease risk in young women with polycystic ovary syndrome. Oncotarget. 2018;9(9):8756–64.
Google Scholar
Ng BK, Lee CL, Lim PS, Othman H, Ismail NAM. Comparison of 25-hydroxyvitamin D and metabolic parameters between women with and without polycystic ovarian syndrome. Horm Mol Biol Clin Invest. 2017;31(3):20160057.
Sim SY, Chin SL, Tan JL, Brown SJ, Cussons AJ, Stuckey BG. Polycystic ovary syndrome in type 2 diabetes: does it predict a more severe phenotype? Fertil Steril. 2016;106(5):1258–63.
Google Scholar
Rubin KH, Glintborg D, Nybo M, Andersen M, Abrahamsen B. Fracture risk is decreased in women with polycystic ovary syndrome: a register-based and population-based cohort study. J Bone Miner Res. 2016;31(4):709–17.
Google Scholar
Merz CNB, Shaw LJ, Azziz R, Stanczyk FZ, Sopko G, Braunstein GD, et al. Cardiovascular disease and 10-year mortality in postmenopausal women with clinical features of polycystic ovary syndrome. J Womens Health. 2016;25(9):875–81.
Glintborg D, Hass Rubin K, Nybo M, Abrahamsen B, Andersen M. Morbidity and medicine prescriptions in a nationwide Danish population of patients diagnosed with polycystic ovary syndrome. Eur J Endocrinol. 2015;172(5):627–38.
Google Scholar
Sirmans SM, Parish RC, Blake S, Wang X. Epidemiology and comorbidities of polycystic ovary syndrome in an indigent population. J Invest Med. 2014;62(6):868–74.
Akbarzadeh M, Moradi F, Dabbaghmanesh MH, Jafari P, Parsanezhad ME. A survey of metabolic syndrome in first-degree relatives (fathers) of patients with polycystic ovarian syndrome. J Endocrinol Metab Diabetes S Afr. 2013;18(2):98–103.
Popova PV, Babenko AY, Grineva EN. The prevalence of type 2 diabetes, arterial hypertension and coronary artery disease in perimenopausal women with polycystic ovary syndrome wedge resected in 1972–1989. Diabetes. 2012;61:A649.
Iftikhar S, Collazo-Clavell ML, Roger VL, St Sauver J, Brown RD Jr, Cha S, et al. Risk of cardiovascular events in patients with polycystic ovary syndrome. Neth J Med. 2012;70(2):74–80.
Google Scholar
Wang ET, Calderon-Margalit R, Cedars MI, Daviglus ML, Merkin SS, Schreiner PJ, et al. Polycystic ovary syndrome and risk for long-term diabetes and dyslipidemia. Obstet Gynecol. 2011;117(1):6–13.
Google Scholar
Schmidt J, Landin-Wilhelmsen K, Brännström M, Dahlgren E. Cardiovascular disease and risk factors in PCOS women of postmenopausal age: a 21-year controlled follow-up study. J Clin Endocrinol Metab. 2011;96(12):3794–803.
Google Scholar
Moran L, Gibson-Helm M, Teede H, Deeks A. Polycystic ovary syndrome: a biopsychosocial understanding in young women to improve knowledge and treatment options. J Psychosom Obstet Gynecol. 2010;31(1):24–31.
Lo JC, Feigenbaum SL, Yang J, Pressman AR, Selby JV, Go AS. Epidemiology and adverse cardiovascular risk profile of diagnosed polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(4):1357–63.
Google Scholar
Margolin E, Zhornitzki T, Kopernik G, Kogan S, Schattner A, Knobler H. Polycystic ovary syndrome in post-menopausal women – marker of the metabolic syndrome. Maturitas. 2005;50(4):331–6.
Google Scholar
Vrbíková J, Cífková R, Jirkovská A, Lánská V, Platilová H, Zamrazil V, et al. Cardiovascular risk factors in young Czech females with polycystic ovary syndrome. Hum Reprod. 2003;18(5):980–4.
Google Scholar
Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at long- term follow-up: a retrospective cohort study. Clin Endocrinol. 2000;52(5):595–600.
Cibula D, Cífková R, Fanta M, Poledne R, Zivny J, Skibová J. Increased risk of non-insulin dependent diabetes mellitus, arterial hypertension and coronary artery disease in perimenopausal women with a history of the polycystic ovary syndrome. Hum Reprod. 2000;15(4):785–9.
Google Scholar
Dahlgren E, Janson PO, Johansson S, Lapidus L, Oden A. Polycystic-ovary-syndrome and risk for myocardial-infarction – evaluated from a risk factor model based on a prospective population study of women. Acta Obstet Gynecol Scand. 1992;71(8):599–604.
Google Scholar
Ollila MM, Arffman RK, Korhonen E, Morin-Papunen L, Franks S, Junttila J, et al. Women with PCOS have an increased risk for cardiovascular disease regardless of diagnostic criteria-a prospective population-based cohort study. Eur J Endocrinol. 2023;189(1):96–105.
Google Scholar
Henney AE, Gillespiec CS, Lai JYM, Schofield P, Riley DR, Caleyachetty R, Barber TM, Miras AD, Dobbie LJ, Hughes DM, Alam U, Hydes TJ, Cuthbertson DJ. Risk of Type 2 Diabetes, MASLD and Cardiovascular Disease in People Living With Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2025;110(5):1235–46. https://doi.org/10.1210/clinem/dgae481. PMID: 38986027; PMCID: PMC12012816.
Al-Hassany L, Linstra KM, Meun C, van den Berg J, Boersma E, Danser AHJ, et al. Decreased role of neuropeptides in the microvascular function in migraine patients with polycystic ovary syndrome. Atherosclerosis. 2023;384:117172.
Google Scholar
Lunde O, Tanbo T. Polycystic ovary syndrome: a follow-up study on diabetes mellitus, cardiovascular disease and malignancy 15–25 years after ovarian wedge resection. Gynecol Endocrinol. 2007;23(12):704–9.
Google Scholar