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Table 1 Characteristics of studies included in the meta-analysis

From: Risk of hypertension in women with polycystic ovary syndrome: a systematic review, meta-analysis and meta-regression

First author, yearCountryStudy designPCOS criteria(a) BP measurement methods and standard conditions (b) Medication for hypertension (c) Diabetes statusPCOS group characteristicsControl group characteristicsUnadjusted RR (95% CI)Quality assessment
Caldernon-Margalit et al. (2014) [2]USAPopulation based prospective cohortNIH(a) Not reported
(b) Not reported
(c) 7.3% diabetic in PCOS and 5.4% in control groups
N = 55
Age:45.4 (3.44); BMI: 29.3 (6.5)
N = 668
Age:45.40 (3.57); BMI: 29.90 (4.73)
1.03 (0.57, 1.85)High
Chan et al. (2013) [34]AustraliaCase-controlRotterdam(a) Not reported
(b) Not reported
(c) 0% diabetic in PCOS vs. 3.7% in control groups
N = 109
Age = not reported; BMI = 31.6 (1.5)
N = 133
Age = not reported; BMI = 25.5 (1.40)
1.49 (0.64, 3.46)Moderate
Chang et al. (2011) [35]USAPopulation based cross-sectionalRotterdam(a) Not reported
(b) Not reported
(c) 9% diabetic in PCOS and 8% in control groups
N = 144
Age = 40 (37–42)*; BMI = 31.7 (26.5–38.1)*
N = 170
Age = 42 (39–45)*; BMI = 28.7 (25.5–33.9)*
1.55 (1.03, 2.34)High
Chang et al. (2016) [3]USAPopulation based cross-sectionalRotterdam(a) Not reported
(b) Not reported
(c) 9.4% diabetic in PCOS vs. 9.3% in control groups
N = 117
Age = 40.6¥; BMI = 31.06¥
N = 204
Age = 39.82¥; BMI = 31.43¥
1.51 (1.0005, 2.28)Moderate
Dahlgren et al. (1992) [4]SwedenProspective cohort studyLaparoscopic PCOS criteria(a) Not reported
(b) Not reported
(c) 31.1% diabetic in PCOS vs. 4.8% in control groups
Group 1 (reproductive): N = 18
Age = 45.9 (2.5); BMI = no reported
Group 22 (Menopause/aging): N = 15
Age = 55.1 (2.6); BMI = no reported
Group 1: N = 57
Age = 46 (2.2); BMI = No reported
Group 2: N = 75
Age = 55.6 (3.1); BMI = no reported
RR for group 1:
7.9 (1.68, 37.16)
RR for group 2:
3.8 (1.91, 7.55)
Moderate
Ding et al. (2018) [7]TaiwanPopulation based prospective cohortICD(a) Note reported
(b) Not reported
(c) 2.94% diabetic in PCOS and 1.46% in control groups
N = 8048
Age = 28.11 (6.89); BMI = not reported
N = 32,192
Age = 28.11 (6.90); BMI = not reported
2.02 (1.73, 2.36)High
Gateva et al. (2012) [5]BulgariaCross-sectionalRotterdam(a) Not reported
(b) Not reported
(c) Not reported
N = 81
Age = mean 25.98; BMI = 36.21 (4.58)
N = 125
Age = 26.5 (5.47); BMI = 37.55 (5.95)
0.95 (0.58, 1.55)Moderate
Glintborg et al. (2015) [36]DenmarkPopulation based cohortRotterdam(a) Not reported
(b) 14% in PCOS and 6.7 in control groups
(c) 2.24% in PCOS vs. 0.4% in control group
N = 20,416
Age = 29.3 (8.5); BMI = 27.3 (23.0–32.7) *
N = 57,483
Age = 30.6 (9.6); BMI = 27.3 (23.0–32.7) *
2.80 (2.44, 3.21)Moderate
Haakova et al. (2003) [49]Czech RepublicCase-controlNIH(a) Not reported
(b) Not reported
(c) 13.64% in PCOS vs. 9.09% in control groups
N = 66
Age = 29.9 (2.97); BMI = 23.7 (4.27)
N = 66
Age = 29.8 (4.94); BMI = 23.2 (3.89)
1.0 (0.06, 15.55)Moderate
Hart et al. (2015) [37]AustraliaPopulation based retrospective cohortICD(a) Not reported
(b) Not reported
(c) 12.5% in PCOS vs. 3.8% in control group
N = 2560
Age = not reported; BMI = not reported
N = 25,660
Age = not reported; BMI = not reported
5.12 (4.05, 6.48)High
Iftikhar et al. (2012) [50]USARetrospective cohortRotterdam(a) Not reported
(b) Not reported
(c) 0.7% in PCOS vs. 2.6% in control
N = 309
Age = not reported; BMI = 29.4 (7.77)
N = 343
Age = not reported; BMI = 28.3 (7.47)
1.22 (0.93, 1.61)High
Lo et al. (2006) [38]USAPopulation based cross-sectionalICD(a) Not reported
(b) Not reported
(c) 9% in PCOS vs. 1.9% in control
N = 11,035
Age = 30.7 (7.2); BMI = not reported
N = 55,175
Age = 30.8 (7.5); BMI = not reported
2.49 (2.35, 2.64)High
Lunde et al. (2007) [51]NorwayProspective cohortLaparoscopic PCOS criteria(a) Not reported
(b) Not reported
(c) 0.74% in PCOS vs. 0% in control
N = 131
Age = mean 24.7; BMI = 24.7
(17.0–36.9) *
N = 723
Age = not reported; BMI = not reported
1.1 (0.43, 2.3)Moderate
Merz et al. (2016) [19]USAPopulation based prospective cohortNIH(a) Not reported
(b) Not reported
(c) 24% in PCOS vs. 32.2% in control
N = 25
Age = 62.6 (11.6); BMI = 28.7 (5.9)
N = 270
Age = 64.8 (9.8); BMI = 30.0 (6.7)
0.76 (0.50, 1.15)High
Meun et. (2018) [39]NetherlandsPopulation based prospective cohortNIH(a) Blood pressure was measured twice at the right brachial artery in sitting position with a random-zero sphygmomanometer
(b) Not reported
(c) 18.9% in PCOS vs. 7% in control
N = 106
Age = 69.57 (8.72); BMI = 27.92 (4.53)
N = 171
Age = 69.20 (8.60); BMI = 26.84 (3.83)
1.06 (0.89, 1.26)High
Okoroh et al. (2015) [40]USAPopulation based cross-sectionalICD(a) Not reported
(b) Not reported
(c) 4.6% in PCOS vs. 1.9% in control
N = 125,268
Age = mean 33.4; BMI = not reported
N = 250,536
Age = mean 33.4; BMI = not reported
2.33 (2.28, 2.38)High
Schmidt et al. (2011) [52]SwedenProspective cohortRotterdam(a) Blood pressure was measured (right arm, supine position) after 15 min rest.
(b) Not reported
(c) 22% in PCOS vs. 14% in control
N = 32
Age = not reported; BMI = not reported
N = 95
Age = not reported; BMI = not reported
1.67 (1.20, 2.33)Moderate
Shi et al. (2014) [53]ChinaRetrospective cohortRotterdam(a) Blood pressure were determined from two blood pressure readings taken at 30-min intervals with the subject seated quietly.
(b) Not reported
(c) Not reported
N = 3396
Age = 30.49 (4.01); BMI = 24.97 (4.15)
N = 1891
Age = 30.73 (4.86); BMI = 22.69 (3.26)
1.61 (1.40, 1.85)Moderate
Shroff et al. (2007) [10]USACase-controlRotterdam(a) Mean systolic and diastolic blood pressure was assessed with two readings after 5 min of seated rest.
(b) Not reported
(c) 4.2% in PCOS vs. 0% in control group
N = 24
Age = 32 (6.5); BMI = 36 (5.4)
N = 24
Age = 36 (7.2); BMI = 35 (3.3)
1.5 (0.27, 8.25)Moderate
Sirmans et al. (2014) [41]USAPopulation based cross-sectionalICD(a) Not reported
(b) Not reported
(c) 17.6% in PCOS vs. 4.7% in control group
N = 1689
Age = mean 25.24; BMI = not reported
N = 5067
Age = mean 25.23; BMI = not reported
2.58 (2.45, 3.32)Moderate
Vrbíková et al. (2003) [54]Czech RepublicCross-sectionalNIH(a) Two blood pressure (BP) readings were obtained in sitting patients after a 10 min rest; the mean was determined from two values and was used for further analysis.
(b) Not reported
(c) 3.1% in PCOS vs. 0% in control group
N = 50
Age = 30.7 (4.2); BMI = 29.20 (7.10)
N = 335
Age = 29.9 (3.10); BMI = 24.10 (4.50)
2.73 (1.46, 5.11)Moderate
Wild et al. (2000) [57]UKPopulation based retrospective cohortLaparoscopic criteria(a) Sitting blood pressures were measured twice in the right arm after participants had been resting for 5 min. Mean values for each individual were used in the analyses.
(b) Not reported
(c) 6.9% in PCOS vs. 3% in control group
N = 1060
Age = not reported; BMI = mean 25.9
N = 319
Age = not reported; BMI = mean 26.6
1.2 (0.95, 1.52)High
Bird et al. (2013) [43]CanadaPopulation based cohortICD(a) Not reported
(b) 6.6 in PCOS vs. 7.1 in control
(c) 20.3% in PCOS vs. 20.7% in control group
N = 43,506
Age = 28.7; BMI = not reported
N = 43,506
Age = 28.9; BMI = not reported
1.27 (1.22, 1.32)Moderate
Li et al. (2013) [44]ChinaPopulation based cross-sectionalRotterdam(a) Not reported
(b) Not reported
(c) Not reported
N = 833
Age = 29.1 (5.4); BMI = 22.2 (4.2)
N = 2732
Age = 32.3 (6.1); BMI = 22.2 (3.4)
1.004 (0.84, 1.20)High
Ramezani Tehrani et al. (2015) [58]IranPopulation based prospective cohortNIH(a) BP were measured twice on the right arm with the subject in a seated position with a standard mercury sphygmomanometer after the subject sat for 15 min; the mean of these 2 measurements was recorded
(b) Not reported
(c) Not reported
N = 85
Age = 29.8 (9.2); BMI = 27.2 (5.3)
N = 552
Age = 29.3 (9.0); BMI = 25.6 (5.0)
1.39 (0.60, 3.23)High
Luque-Ramirez et al. (2007) [55]SpainCase-controlAES(a) Ambulatory blood pressure monitoring
(b) Not reported
(c) Not reported
N = 36
Age = 24.2 (6.2); BMI = 29.3 (6.4)
N = 20
Age = 26.7 (6.8); BMI = 28.2 (6.9)
0.83 (0.41, 1.68)Moderate
Ramezani Tehrani et al. (2011) [46]IranPopulation based cross-sectionalRotterdam(a) Not reported
(b) Not reported
(c) Not reported
N = 136
Age = 32.4 (25.9–38.8)*; BMI = 25.9 (23.5–32.6)*
N = 423
Age = 36 (30–41.0) *; BMI = 26.4 (23.1–29.4) *
1.04 (0.29, 3.79)High
Ramezani Tehrani et al. (2014) [47]IranPopulation based cross-sectionalRotterdam(a) BP were measured twice on the right arm with the subject in a seated position with a standard mercury sphygmomanometer after the subject sat for 15 min; the mean of these 2 measurements was recorded
(b) Not reported
(c) Not reported
N = 85
Age = 29.02 (7.4)*; BMI = 26.5 (5.8)
N = 517
Age = 33.9 (7.6); BMI = 26.6 (5)
0.68 (0.09, 5.20)High
Marchesan et al. (2019) [56]BrazilCross-sectionalRotterdam(a) Blood pressure (measured after a 10-min rest, in the sitting position, with feet on the floor and the arm supported at heart level
(b) Not reported
(c) Not reported
N = 180
Age = 25 (21–29)*; BMI =32.52 (7.41)
N = 70
Age = 29 (26–34)*; BMI =28.71 (5.71)
2.29 (1.20, 4.37)High
Behboudi-Gandevani et al. (2018) [48]IranPopulation based cohort studyNIH(a) BP were measured twice on the right arm with the subject in a seated position with a standard mercury sphygmomanometer after the subject sat for 15 min; the mean of these 2 measurements was recorded
(b) Not reported
(c) 1.1% in PCOS vs. 2.1% in control group
Group 1 (reproductive): N = 131
Age = 25.28 (7.69); BMI =25.89 (5.13)
Group 2 (Menopause/aging): N = 28
Age = 46.19 (11.02); BMI =29.53 (4.51)
Group 1: N = 1046
Age = 26.57 (7.51); BMI = 24.89 (4.9)
Group 2: N = 355
Age = 49.46 (6.26); BMI = 29.32 (4.57)
Group 1: 1.29 (0.89, 1.87)
Group 2: 1.01 (0.61–1.68)
High
  1. Abbreviations: PCOS Polycystic ovary syndrome, N Number, RR Relative risk, CI Confidence interval, NIH National Institutes of Health, ICD International Classification of Diseases
  2. *Values represent median and interquartile
  3. € Values represent mean; standard deviation is not reported
  4. ¥ Values represent median; interquartile range is not reported