ABC | Volume 112, Nº4, April 2019

Original Article Women with Polycystic Ovarian Syndrome Exhibit Reduced Baroreflex Sensitivity That May Be Associated with Increased Body Fat Stella Vieira Philbois , A da Clarice Gastaldi , Tábata de Paula Facioli , A na Carolina Sanches Felix , Rosana Maria dos Reis , Thauane Hanna Fares, Hugo Celso Dutra de Souz a Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP – Brazil Mailing Address: Hugo Celso Dutra de Souza • Rua Luís Basso, 130. Postal Code 14040-150, Jardim Recreio, Ribeirão Preto, SP – Brazil E-mail: hugocds@fmrp.usp.br , hugousp@gmail.com Manuscript received May 08, 2018, revised manuscript July 25, 2018, accepted August 15, 2018 DOI: 10.5935/abc.20190031 Abstract Background: Polycystic ovarian syndrome (PCOS) women have a high prevalence of obesity and alterations in cardiovascular autonomic control, mainly modifications in heart rate variability (HRV) autonomic modulation. However, there are few studies about other autonomic control parameters, such as blood pressure variability (BPV) and baroreflex sensitivity (BRS). In addition, there are still doubts about the obesity real contribution in altering autonomic control in these women. Objective: To investigate BPV and BRS autonomic modulation alterations in PCOS women, as well as, to evaluate whether these alterations are due PCOS or increased body fat. Methods: We studied 30 eutrophic volunteers [body mass index (BMI) < 25 kg/m 2 ] without PCOS (control group) and 60 volunteers with PCOS divided into: eutrophic (BMI < 25 kg/m 2 , N = 30) and obese women (BMI > 30 kg/m 2 , N = 30). All volunteers were submitted to anthropometric evaluation, hemodynamic and cardiorespiratory parameters record at rest and during physical exercise, analysis of HRV, BPV and spontaneous BRS. The differences in p less than 5% (p < 0.05) were considered statistically significant. Results: Related to eutrophics groups, there were no differences in autonomic parameters evaluated. The comparison between the PCOS groups showed that both PCOS groups did not differ in the BPV analysis. Although, the obese PCOS group presented lower values of spontaneous BRS and HRV, in low frequency and high frequency oscillations in absolute units. Conclusion: Our results suggest that obesity did little to alter HRV in women with PCOS, but it may influence the spontaneous BRS. (Arq Bras Cardiol. 2019; 112(4):424-429) Keywords: Obesity; Hypertension; Polycystic Ovary Syndrome/physiopathology; Adiposity; Body Fat Distribution; Autonomic Nervous System; Heart Rate. Introduction Women with polycystic ovarian syndrome (PCOS) frequently present cardiovascular autonomic control impairments, mainly characterized by a cardiac autonomic imbalance in determining heart rate variability (HRV). 1-4 This imbalance is an important cardiovascular diseases risk predictor. 5-7 The autonomic impairment causes are still not well established. Some studies suggest that they are result of hormonal and metabolic disorders due PCOS, such as insulin resistance increased. 2,3,8 On the other hand, it is possible that they are simply due body fat percentage increase, which triggers series of systemic alterations, including metabolic and cardiovascular, that affect the cardiac autonomic control. 4,9,10 Another important aspect is that only HRV is frequently investigated in these women, and we know little about PCOS effects on others autonomic parameters, such as baroreflex sensitivity (BRS) and blood pressure variability (BPV). More specifically, there are no studies associating PCOS to BPV, and in BRS case, studies are incipient. On this, only one study was performed and found no differences. 11 However, this study only addressed obese PCOS and non-PCOS women, which limited further findings. Therefore, the aim of the present study was to evaluate spontaneous BRS and BPV in eutrophic PCOS women and to investigate the contribution of obesity to these autonomic parameters in these women. Methods Participants With a convenience sample, ninety volunteers aged between 18 and 39 years were included, 30 non PCOS women, considered as a control group, and 60 PCOS women, according to Rotterdam consensus, 12 were subdivided according to the body mass index (BMI): eutrophic group (30 women) and obese group (30 women). All of them were sedentary, did not 424