Interrelations between carbohydrates, lipids and the hemostatic system in relation to the risk of thrombotic and cardiovascular disease

Article Abstract:

Altered carbohydrate and lipid metabolism plays a role in the development of atherosclerosis and cardiovascular disease. Risk factors for cardiovascular disease include obesity, diabetes, increased blood cholesterol and increased triglycerides. Abnormalities in the blood clotting mechanism are involved in various problems affecting the cardiovascular system. Hyperinsulinemia, increased circulating insulin, has been described in obese patients, patients with impaired glucose tolerance, diabetics and patients with increased blood triglycerides. It is theorized that a common abnormality exists in all these pathological states. There is, in fact, a correlation between the amount of circulating insulin and body mass index (a ratio of height to weight), triglyceride levels and plasminogen activator inhibitor-1 (PAI-1), a chemical involved in the formation of blood clots. Insulin stimulates the production of PAI-1, which in turn increases the formation of fibrin, the basic constituent of blood clots. It is thought that this sequence of events leads to the formation of blood clots that can block blood vessels at points where there is atherosclerotic plaque (atherothrombosis). Thus it seems that increased insulin and lipoproteins in blood produce changes within the blood vessels that lead to the development of atherothrombosis. Since both of these conditions generally occur simultaneously, their effects are probably cumulative. (Consumer Summary produced by Reliance Medical Information, Inc.)

Reports, Development and progression, Coronary heart disease, Lipid metabolism, Carbohydrate metabolism, Cardiovascular research, Insulin

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Contraception and dyslipidemia

Article Abstract:

Women with dyslipidemia may still be candidates for combination oral contraceptive (OC) use if they are able to control their cholesterol levels and have no other risk factors for developing coronary heart disease. Dyslipidemia refers to the abnormal metabolism of fatty acids such as cholesterol. Elevated levels of certain fatty acids are associated with cardiovascular diseases. Combination OCs are formulated with estrogen and progestin. Estrogen is thought to have beneficial effects on the metabolism of cholesterol. Guidelines for prescribing OCs to women with dyslipidemia include evaluating other risk factors for cardiovascular disease such as smoking, presence of diabetes, high blood pressure, family history of heart disease and age. Blood lipid levels should be carefully monitored by the practitioner.

Contraception, Dyslipoproteinemias

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Bias versus causality: interpreting recent evidence of oral contraceptive studies

Article Abstract:

Studies showing an increased risk of excessive blood clotting in third-generation oral contraceptive users may be biased. These contraceptives contain low doses of estrogen combined with progesterone-like drugs such as gestodene and desogestrel. Several types of bias may enter into clinical trials, and this is a more likely explanation for the increased risk seen in these studies. This complication of oral contraceptive use is still very rare, and most oral contraceptives are safe.

Complications and side effects, Oral contraceptives, Thrombosis, Deep vein, Deep vein thrombosis

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