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Effects of metformin versus ethinyl-estradiol plus cyproterone acetate on ambulatory blood pressure monitoring and carotid intima media thickness in women with the polycystic ovary syndrome.

Author(s): Luque-Ramirez M, Mendieta-Azcona C, Alvarez-Blasco F, Escobar-Morreale HF

Affiliation(s): Department of Endocrinology, Hospital Universitario Ramon y Cajal and Universidad de Alcala, Madrid, Spain.

Publication date & source: 2009-06, Fertil Steril., 91(6):2527-36. Epub 2008 Jun 18.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVE: To compare the effects of metformin versus an antiandrogenic contraceptive pill on ambulatory blood pressure monitoring (ABPM) and carotid intima media thickness (CIMT) in women with polycystic ovary syndrome (PCOS). DESIGN: Clinical randomized trial. SETTING: Academic hospital. PATIENT(S): Thirty-four consecutive PCOS patients. INTERVENTION(S): PCOS patients randomized to oral treatment with metformin (n = 19) or with Diane(35) Diario pill (n = 15) for 24 weeks. MAIN OUTCOME MEASURE(S): ABPM recordings and ultrasound measurements of CIMT as marker of subclinical atherosclerosis obtained at baseline and after treatment. RESULT(S): Metformin resulted in reductions in daytime and 24-hour average systolic and diastolic blood pressure whereas Diane(35) Diario induced a slight increase in these parameters. Compared with a nonhyperandrogenic control group, the increased CIMT values of PCOS patients decreased to the normal range after treatment with either metformin or Diane(35) Diario. CONCLUSION(S): Metformin treatment decreased daytime ABPM recordings whereas Diane(35) Diario exerted the opposite effect. The safer blood pressure profile of metformin should be considered in PCOS patients who present with a history of hypertension or who are at risk for this disorder. Treatment with either Diane(35) Diario or metformin improved CIMT mean values.

Page last updated: 2009-10-20

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