Hypertension and Polycystic Ovary Syndrome Among Women in a Nationwide Electronic Health Records Dataset in the United States.

Introduction: Both hypertension and polycystic ovary syndrome (PCOS) are risk factors for future cardiovascular diseases among women of reproductive age (18-44 years). We constructed an electronic health record (EHR)-based PCOS phenotype, reported PCOS prevalence, and investigated the association of PCOS and hypertension in the United States (US).

Methods: This cross-sectional study used 2022 IQVIA's Ambulatory Electronic Medical Record (AEMR)-US data (May 2023 release). We constructed a phenotype for PCOS and reported PCOS prevalence for eligible women. We then described hypertension prevalence and hypertension control estimates stratified by PCOS status. Lastly, we calculated adjusted prevalence ratios (aPR) for hypertension and hypertension control by PCOS status, adjusting for age, race, and body mass index (BMI).

Results: We analyzed records for 1,301,425 eligible women, with mean (standard deviation) age of 31.5 (7.9) years. The prevalence of PCOS was 2.1%, but increased with weight category, reaching 6.7% among those with class 3 obesity (BMI ≥ 40 kg/m²). Women with PCOS had 50% higher prevalence of hypertension than those without PCOS (aPR 1.50; 95% confidence interval [CI]: 1.48-1.52; p < 0.001), and slightly higher hypertension control prevalence (aPR 1.14; 95% CI: 1.12-1.17; p < 0.001).

Discussion: Using a nationwide EHR dataset, we observed that women with PCOS had substantially higher hypertension prevalence than those without PCOS. PCOS prevalence was lower than previous estimates from global surveys. Following guideline-recommended blood pressure screening for women with PCOS could reduce the risk of long-term cardiovascular disease.