Combined androgen excess polycystic ovary syndrome and obesity are associated with elevated blood pressure variability in adult women

Androgen excess polycystic ovary syndrome (AE-PCOS) is a common endocrine-metabolic disorder in women of reproductive age and is associated with elevated cardiovascular disease risk. However, the relationship between AE-PCOS and blood pressure variability (BPV), a marker of cardiovascular disease risk, has not been investigated. The purpose of this study was to examine BPV across obese women with AE-PCOS and lean and obese healthy control women. We hypothesized that BPV would be elevated in women with AE-PCOS compared to obese and lean women without AE-PCOS. We recruited 14 women with AE-PCOS (27±6 y; 37.9±5.6 kg·m 2 , 27.1–44. 8 kg·m 2 ), and 12 obese (27±5 y; 35.6±6.0 kg·m 2 , 27.4–50.3 kg·m 2 ) and 25 lean women (26±6 y; 22.9±3.6 kgxm 2 , 19.2–33.1 kg·m 2 ) without AE-PCOS. Beat-to-beat BP was measured via finger photoplethysmography (Finometer Pro) over a 6 min resting period. Standard deviation (SD), coefficient of variation (CV), average real variability (ARV), and range were calculated for systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP). We used Kruskal-Wallis one-way ANOVA with multiple comparisons to assess differences between measurements of BPV across groups. Data are presented as mean±SD with significance set at α = 0.05. Women with AE-PCOS had elevated resting SBP (lean: 113±12 mmHg; AE-PCOS: 125±9 mmHg; P = 0.002), DBP (lean: 73±8 mmHg; AE-PCOS: 82±8 mmHg; P = 0.006), and MAP (lean: 86±9 mmHg; AE-PCOS: 96±8 mmHg, P = 0.009) compared to lean controls. Resting blood pressure in obese women without AE-PCOS was similar to lean women and to women with AE-PCOS. Compared to lean controls, obese women with AE-PCOS had elevated ARV for SBP (lean: 1.6±0.4 mmHg; AE-PCOS: 2.5±0.7 mmHg, P=0.001), DBP (P=0.005), and MAP (P=0.033). In addition, DBP SD was also greater in AE-PCOS compared to lean controls (lean: 3±1 mmHg; AE-PCOS: 4±1 mmHg, P=0.005). Whereas only SBP ARV was elevated in obese controls compared to lean controls (P=0.043). These preliminary findings suggest that obese women with AE-PCOS exhibit increased BPV, which may contribute to the greater risk for cardiovascular disease in this group. NIH HL135089/P20GM 121334/R01HL161000 This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.