Evidence for increased cardiovascular events in the fathers but not mothers of women with polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is a familial syndrome, associated with multiple cardiovascular disease (CVD) risk factors. Thus, parents of affected women may have a higher prevalence of CVD events than the general population. Methods: PCOS probands (n 410) and their participating parents (n 180 fathers and 211 mothers) were queried for CVD events in themselves and non-participating family members. In order to include the family CVD history of all parents, agreement between the proband and parental reports of CVD events was assessed. Estimated 10-year coronary heart disease (CHD) risk was calculated using the Framingham risk calculator. The National Health and Nutrition Examination Survey (NHANES) 20012002 database was used to generate gender, age and body mass index-relevant population parameters of CVD prevalence in the USA population. Results: Ninety-eight percent of the parents self-reporting of CVD events agreed with the probands report of parental heart attack history [Kappa 0.82; 95 CI: (0.69, 0.94)] and 99 with parental stroke history [Kappa=0.79; 95 CI: (0.62, 0.97)]. Fathers of women with PCOS had a higher prevalence of heart attack and stroke compared with the reference NHANES population (heart attack: 11.1 versus 5.3, P < 0.0001; stroke: 3.0 versus 1.0, P 0.002). Fathers of women with PCOS had an elevated 10-year risk for CHD (11.5 versus 9.9 in NHANES, P=0.03). No statistically significant increased prevalence of CVD events or 10-year risk was noted in probands or mothers. Conclusions: Fathers, and not mothers, may be disproportionately burdened with CVD in PCOS families. The strengths of this study include the size of our cohort, the consistent phenotyping and the validation of probands reporting of parental CVD events.