Abstract
In recent years, the prevalence of polycystic ovary syndrome (PCOS) has gradually increased, and the investigation of the causal factors influencing etiopathogenesis is attracting attention. Several studies have highlighted that patients with PCOS exhibit an increased risk of cardiovascular disease (CVD) compared with healthy people, and these risks include the occurrence of myocardial infarction, ischemic heart disease, and stroke. This correlation becomes particularly important when PCOS is diagnosed and consequently a specific treatment is recommended. Of note, women with PCOS may exhibit different pathological features even if quite often they are considered as a sole unique group of patients. Interestingly, the rate of CVD occurrence is differently linked to PCOS phenotypes. Data from literature demonstrate that CVD risks are strongly associated with those comorbidities frequently observed in PCOS, mainly metabolic alterations such as hypertension, abdominal obesity, dyslipidemia, insulin resistance, and atherosclerosis, that predispose individuals to CVD and type 2 diabetes. Women presenting PCOS, particularly those with a hyperandrogenic pattern, seem more prone to develop CVD with respect to other PCOS patients. This may be related to genetic factors, dyslipidemia, and hypertension combined with excessive androgen, which may explain the increased risk factor of CVD in patients with PCOS. On these premises, it becomes important to implement the therapeutic rationale and the risk assessment before treatment prescription and to encourage meticulous patient observation during medical examinations. This aspect becomes crucial particularly in adolescent patients, as in many cases, PCOS may be predictive of CVD occurrence.