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Reproductive Biology and Endocrinology

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Open Access 01-12-2018 | Research

Morning blood pressure surge and its relation to insulin resistance in patients of reproductive age with polycystic ovary syndrome

Authors: Hasan Kadi, Eyup Avci, Akin Usta, Abdullah Orhan Demirtaş

Published in: Reproductive Biology and Endocrinology | Issue 1/2018

Abstract

Background

Our aim in this study was to investigate morning blood pressure surge (MBPS) in patients of reproductive age with polycystic ovary syndrome (PCOS) and its relation to insulin resistance (IR).

Methods

Fifty-three patients with PCOS without additional illness were included in the study. Forty-two age-matched subjects without PCOS were selected as the control group. All study subjects underwent 24-h blood pressure monitoring. Patients with additional illnesses, drug users, smokers, and alcohol and drug abusers were excluded. Blood insulin, fasting glucose, lipid profile, and hormone profile were measured. Insulin resistance was calculated using the HOMA-IR formula.

Results

Median age (years) was 27 (20–33) in the PCOS group and 27 (22–33) in the control group. Body mass index was higher in the PCOS group. Office systolic and diastolic blood pressure was higher in the PCOS group. Mean awakening 2-h BPs (mmHg) was 110 ± 7 in the control group and 118 ± 5 in the PCOS group (p < 0.001). Mean MBPS (mmHg) was 21 ± 6 in the control group and 29 ± 8 in the PCOS group. Mean MBPS was higher in the PCOS group (p < 0.001). IR was more frequent in the PCOS group. Based on logistic regression analysis, the presence of PCOS and IR were independent predictors for MBPS.

Conclusions

The results of our study showed that MBPS increased excessively when compared to non-PCOS controls in young women with PCOS during reproductive age. In addition, PCOS and insulin resistance were independent risk factors for exaggerated MBPS.

Carmina E, Rosato F, Janni A, Rizzo M, Longo RA. Extensive clinical experience: relative prevalence of diff erent androgen excess disorders in 950 women referred because of clinical hyperandrogenism. J Clin Endocrinol Metab. 2006;91:2–6.CrossRefPubMed

Ehrmann DA. Polycystic ovary syndrome. N Engl J Med. 2005;352:1223–36.CrossRefPubMed

Asuncion M, Calvo RM, San Millan JL, Sancho J, Avila S, Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85:2434–8.PubMed

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;52:595–600.CrossRef

Toprak S, Yönem A, Cakir B, Güler S, Azal O, Ozata M, et al. Insulin resistance in nonobese patients with polycystic ovarysyndrome. Horm Res. 2001;55:65–70.PubMed

Amato MC, Vesco R, Vigneri E, Ciresi A, Giordano C. Hyperinsulinism and polycystic ovary syndrome (PCOS): role of insulin clearance. J Endocrinol Investig. 2015;38:1319–26.CrossRef

Apridonidze T, Essah PA, Iuorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90:1929–35.CrossRefPubMed

Kario K, Pickering TG, Umeda Y, Hoshide S, Hoshide Y, Morinari M, et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation. 2003;107:1401–6.CrossRefPubMed

Kario K. Morning surge in blood pressure and cardiovascular risk evidence and perspectives. Hypertension. 2010;56:765–73.CrossRefPubMed

10.

Kario K, White WB. Early morning hypertension: what does it contribute to overall cardiovascular risk assessment? J Am Soc Hypertens. 2008;2:397–402.CrossRefPubMed

11.

Haffner SM, Miettinen H, Stern MP. The homeostasis model in the San Antonio heart study. Diabetes Care. 1997;20:1087–92.CrossRefPubMed

12.

The Rotterdam ESHRE/ASRM–Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41–7.CrossRef

13.

Legro RS, Gnatuk CL, Kunselman AR, Dunaif A. Changes in glucose tolerance over time in women with polycystic ovary syndrome: a controlled study. J Clin Endocrinol Metab. 2005;90:3236–42.CrossRefPubMed

14.

Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989;38:1165–74.CrossRefPubMed

15.

Teede HJ, Hutchison S, Zoungas S, Meyer C. Insulin resistance, the metabolic syndrome, diabetes, and cardiovascular disease risk in women with PCOS. Endocrine. 2006;30:45–53.CrossRefPubMed

16.

Carmina E, Napoli N, Longo RA, Rini GB, Lobo RA. Metabolic syndrome in polycystic ovary syndrome (PCOS): lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS. Eur J Endocrinol. 2006;154:141–5.CrossRefPubMed

17.

Cheung LP, Ma RC, Lam PM, Lok IH, Haines CJ, So WY, et al. Cardiovascular risks and metabolic syndrome in Hong Kong Chinese women with polycystic ovary syndrome. Hum Reprod. 2008;23:1431–8.CrossRefPubMed

18.

Cheng C, Zhang H, Zhao Y, Li R, Qiao J. Paternal history of diabetes mellitus and hypertension affects the prevalence and phenotype of PCOS. J Assist Reprod Genet. 2015;32:1731–9.CrossRefPubMedPubMedCentral

19.

Luque-Ramírez M, Martí D, Fernández-Durán E, Alpañés M, Álvarez-Blasco F, Escobar-Morreale HF. Office blood pressure, ambulatory blood pressure monitoring, and echocardiographic abnormalities in women with polycystic ovary syndrome: role of obesity and androgen excess. Hypertension. 2014;63:624–9.CrossRefPubMed

20.

Holte J, Gennarelli G, Berne C, Bergh T, Lithell H. Elevated ambulatory day-time blood pressure in women with polycystic ovary syndrome: a sign of a pre-hypertensive state? Hum Reprod. 1996;11:23–8.CrossRefPubMed

21.

Luque-Ramírez M, Alvarez-Blasco F, Mendieta-Azcona C, Botella-Carretero JI, Escobar-Morreale HF. Obesity is the major determinant of the abnormalities in blood pressure found in young women with the polycystic ovary syndrome. J Clin Endocrinol Metab. 2007;92:2141–8.CrossRefPubMed

22.

Amici A, Cicconetti P, Sagrafoli C, Baratta A, Passador P, Pecci T, et al. Exaggerated morning blood pressure surge and cardiovascular events. A 5-year longitudinal study in normotensive and well-controlled hypertensive elderly. Arch Gerontol Geriatr. 2009;49:e105–9.CrossRefPubMed

23.

Sheppard JP, Hodgkinson J, Riley R, Martin U, Bayliss S, McManus RJ. Prognostic significance of the morning blood pressure surge in clinical practice: a systematic review. Am J Hypertens. 2015;28:30–41.CrossRefPubMed

24.

Li Y, Thijs L, Hansen TW, Kikuya M, Boggia J, Richart T, et al. Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations. Hypertension. 2010;55:1040–8.CrossRefPubMed

Title: Morning blood pressure surge and its relation to insulin resistance in patients of reproductive age with polycystic ovary syndrome
Authors: Hasan Kadi
Eyup Avci
Akin Usta
Abdullah Orhan Demirtaş
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Reproductive Biology and Endocrinology / Issue 1/2018
Electronic ISSN: 1477-7827
DOI: https://doi.org/10.1186/s12958-018-0394-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Morning blood pressure surge and its relation to insulin resistance in patients of reproductive age with polycystic ovary syndrome

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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