Diagnosis of Polycystic Ovary Syndrome and Non-Hispanic Black Race Are Predictive of Hypertension in Reproductive Age Women with Polycystic Ovary Syndrome

<b><i>Introdution:</i></b> Hypertension (HTN), metabolic syndrome (MetS), and obesity are common in women with polycystic ovary syndrome (PCOS); these comorbidities may be more common in non-Hispanic Black (NHB) and Hispanic women with PCOS. <b><i>Methods:</i></b> We examined electronic health records in an academic health care system using International Classification of Diseases, Tenth Revision, diagnostic codes to identify PCOS cases (<i>n</i> = 4,479) and control women (<i>n</i> = 771). We examined associations between PCOS and blood pressure (BP) (<i>elevated BP [Stage 0 HTN], Stage 1, Stage 2 HTN, and overall HTN [Stages 1 and 2]</i>), with obesity (class 1 [body mass index or BMI, 30-<35 kg/m²], class 2 [BMI, 35-<40 kg/m²], and class 3 [BMI, ≥40 kg/m²]), and pre-metabolic syndrome (pre-MetS). Analyses were stratified by obese, BMI ≥30 kg/m² versus nonobese, BMI <30 kg/m². Age, race, and ethnicity were included as covariates for all adjusted analyses. Associations are presented as adjusted odds ratio (aOR) and 95% confidence interval (CI) for logistic regression and β coefficient (SEM) for linear regression analyses. PCOS had higher BMI (33 [27-40]) than controls (29 [23-33], <i>p</i> = 0.001), and obese PCOS had 35% greater HTN incidence (aOR 1.35, 95% CI 1.05-1.75). <b><i>Results:</i></b> Independent of PCOS, nonobese NHB were ∼60% more likely to be hypertensive (aOR 1.57, 95% CI 1.14-2.17). Obese Hispanic women were less likely to have Stage 1 (aOR 0.59, 95% CI 0.46-0.75), whereas nonobese Hispanic women were more likely to have Stage 1 (aOR 1.52, 95% CI 1.04-2.24) HTN. PCOS was six-fold more likely to have class 3 obesity versus controls (aOR 6.29, 95% CI 4.60-8.60). Adjusting for age, race, and ethnicity, PCOS (aOR 2.25, 95% CI 1.77-2.86) and NHB (aOR 1.83, 95% CI 1.53-2.20) had an increased likelihood for pre-MetS. <b><i>Conclusions:</i></b> Independent of PCOS, nonobese NHB women were more likely to be hypertensive and pre-MetS compared with other races. Our findings indicate roles for race and ethnicity on BP and metabolic regulation in PCOS.