Introduction and summary statements

Long-term metabolic, cardiovascular and neoplastic risks with polycystic ovary syndrome

Metabolic abnormalities and obesity have long been associated with the development of cardiovascular disease in the general population. These same features are also associated with polycystic ovary syndrome (PCOS). An increased prevalence of hypertension, dyslipidaemia, obesity and hyperinsulinaemia, as well as changes in coagulation and blood vessel function, provide an explanation as to why women with PCOS are at an increased risk of developing cardiovascular disease over the long term.

Type 2 Diabetes and Chronic Systolic Heart Failure

Diabetes is a chronic progressive endocrinopathy associated with significant macrovascular and microvascular complications as well as cardiomyopathy and heart failure (HF). Diabetes and chronic systolic HF result in similar activation of pathologic neurohormonal pathways. When diabetes and HF coexist, morbidity and mortality significantly increase. This article reviews important clinical issues in the care of patients with diabetes and HF. A review of pertinent pathophysiologic principles is provided, followed by a discussion of the treatment issues related to this population. Treatment issues include vascular disease risk factor modification, HF pharmacotherapy, glycemic management, and control of other common comorbid conditions.