Elevated diastolic blood pressure in insulin-resistant polycystic ovarian syndrome patients.

OBJECTIVE: The purpose of this study was to further understand interrelationships between insulin resistance in PCOS and elevated diastolic blood pressure. DESIGN: A prospective case control study. PARTICIPANTS: Fifty normal women and 43 PCOS patients, 16 of them with insulin resistance. SETTING: Academic Institution. INTERVENTIONS: Clinical, anthropometric and ultrasonographic features of PCOS were assessed, as were blood levels for luteinizing hormone, follicle-stimulating hormone, androstenedione, DHEAS, and basal insulin. A lipid profile and an oral glucose tolerance test (OGTT) were also performed. MAIN OUTCOME MEASURES: To demonstrate the effect of insulin resistance on blood pressure in patients with PCOS. RESULTS: Patients with PCOS and those with PCOS plus insulin resistance (IR) had significantly elevated levels of plasma androgen but only those with IR showed greater body mass index and waist: hip ratios than PCOS or control. PCOS plus IR differed significantly in their response to OGTT when compared to PCOS or control. Alterations in lipid profile were shown to be atherogenic. Patients with PCOS plus IR demonstrated a significant elevation of diastolic blood pressure when compared to PCOS alone or controls. CONCLUSIONS: We hypothesize that hyperlipidemia and IR may be involved in the pathophysiologic features of the elevated diastolic blood pressure in PCOS patients.