Polikistik Over Sendromu ve Kan Basıncı Yüksekliği (Hipertansiyon)

Kalp ve damar hastalığı (kalp, beyin ve bacaklara oksijen taşıyan damarların tıkanması veya daralması) ihtimalini arttıran özelliklerden bir tanesi kan basıncı yüksekliği (hipertansiyon) dir.   Bu özelliklerden en az 3 tanesi biraraya gelerek metabolik sendromu oluşturmaktadır(1,2,3,4);

1-Kan basıncı yüksekliği (≥ 130 /85 mmHg)

2-Vücudun üst kısmında yani karın ve bel bölgesinde bulunan yağ miktarının artması (bel çevresi ≥ 80 cm)

3-Açlık kan şekeri (glukoz) yüksekliği (≥ 100 mg/dL)

4-Kan yağlarından faydalı olan HDL-C miktarının azalması (≤ 50 mg/dL)

5-Kan yağlarından trigliserid miktarının artması ( ≥150 mg/dL)

Polikistik over sendromu olan kadınlarda metabolik sendrom daha sık görülmektedir.(5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29).

Kalp ve damar hastalığı ihtimalini arttıran metabolik sendrom’un özelliklerden biri de kan basıncının yüksek (130 /80 mmHg) olmasıdır(30,31). Polikistik over sendromu olan kadınlarda kan basıncı yüksekliği sık görülmektedir(30,31,32). Bu kadınlarda kan basıncını en çok insülin direnci etkilemektedir(33). Erkeklik hormonlarının (androgen) etkisinin fazla olması (hiperandrogenism) da kan basıncını insülin direncinden daha az olmakla birlikte etkilemektedir(58,34,35,36).

Polikistik over sendromu olan kadınların kalp ve damar hastalıkları açısından mutlaka değerlendirilmesi gerekmektedir! Bu kadınların çok genç yaşlarda adet düzensizliği, çocuk isteği, tüylenme artışı, sivilce ve saç dökülmesi için kadın doğum uzmanına ya da cildiye uzmanına başvurmaları aslında yüksek olan kalp ve damar hastalıkları ve metabolik sendrom riskinin erken yaşlarda tespit edilmesi açısından önemli bir avantaj sağlamaktadır. Fakat, maalesef çoğunlukla kendi branşlarının dışında olduğu için ya da hastanın başvuru şikayetiyle ilgili olmadığı için kadın doğum ve cildiye uzmanları çok basit bir şekilde ölçülebilen kan basıncı, bel ve basen çevresi ölçümünü çoğunlukla yapmamaktadır. Çok genç yaşlarda doktora başvurmalarına rağmen bu kadınlarda sorun çıkma ihtimali yüksek olan kan yağları (trigliserid, kolesterol), insülin direnci, bozulmuş şeker toleransı ve şeker hastalığı testleri de çoğunlukla yapılmamaktadır.

Kaynaklar

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2-National Institues of Health. Third Report of the Cholesterol Education Program Expert Panel on Detection, Ealuation, and Treatment of High blood Cholesterol in Adults (Adult Treatment Panel III). NIH Publication 01-3670. Bethesda, MD:  National Institues of Health. 2001.

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