Oral contraceptives, lipoproteins, and atherosclerosis

Article Abstract:

Studies have related decreased blood levels of HDL (high-density lipoproteins), a type of cholesterol-transporting particle in the blood, with increased risk of coronary artery disease. Oral contraceptives lower HDL levels and thus may constitute a risk for development of coronary artery disease. However, this drug effect on lipoproteins may not be equivalent to the observed epidemiological relationship. In addition, no obvious linkage between contraceptive use and coronary artery disease occurrence has been observed. To better determine the relationship, if any, between contraceptive use and risk of coronary artery disease, the development of atherosclerosis in macaque monkeys treated with hormones was studied. The cardiovascular and reproductive systems of macaques resemble those of humans. Two studies with macaques indicated that although oral contraceptive treatment decreased blood levels of HDL, particularly the protective HDL2 subfraction, and increased blood levels of cholesterol and fat, there was a decreased development of coronary artery disease-linked blood vessel changes, compared with untreated animals. Thus, the study strongly suggests that oral contraceptive use actually inhibits atherosclerosis, possibly due to direct effects on blood vessel walls and their metabolism of lipoproteins. (Consumer Summary produced by Reliance Medical Information, Inc.)

Lipoproteins

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Low-dose oral contraceptives and carbohydrate metabolism

Article Abstract:

It is thought that the risk of developing diabetes mellitus is greater among women whose glucose metabolism is altered because they are using oral contraceptives (OCs). Although an increased prevalence of overt symptoms of diabetes mellitus has not been seen, it is likely that the effects of OCs on glucose metabolism may not appear for a long period of time. Most studies have not examined the long-term effects of OC use by young women. The few studies finding no change in glucose tolerance with OC use had poor study designs. There is a strong and consistent association between OC use and coronary heart disease. People with diabetes mellitus, particularly women, have an increased risk of cardiovascular disease. Increased blood levels of glucose (hyperglucosemia) and insulin (hyperinsulinemia) have been linked with coronary heart disease and the promotion of atherosclerotic plaque formation. A review of studies examining the effects of new low-dose OC pills on carbohydrate metabolism found that altered glucose tolerance still occurs, despite the reduction in the hormone content. The intensity of these changes may depend on the type, schedule and concentration of progestogens used in the OC pill formula. Therefore, the new formulas still carry a risk of cardiovascular disease, although somewhat reduced. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diabetes, Diabetes mellitus, Carbohydrate metabolism, Glucose metabolism

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Effects of 17 alpha-dihydroequilenin sulfate on atherosclerotic male and female rhesus monkeys

Article Abstract:

Treatment with the hormone 17a-dihydroequilenin (DHEN) may be effective in reducing obstructive heart disease in men and women past menopause. Researchers evaluated the effects of five weeks of DHEN treatment, estradiol treatment, or no treatment in 33 adult male and 50 adult female rhesus monkeys fed a lifetime high-fat diet. DHEN treatment prevented vessel constriction during vessel scans in intact males and in females with their ovaries removed. Uterus and breast tissue were equally deteriorated in all treatment groups. Treatments did not affect the amount of vessel blockage in any group.

Evaluation, Prevention, Hormone therapy, Progesterone, Estradiol

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