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Oral contraceptives and coronary heart disease: modulation of glucose tolerance and plasma lipid risk factors by progestins.
Am J Obstet Gynecol. 1988 Jun; 158(6 Pt 2):1612-20.AJ

Abstract

Widespread use of oral contraceptive formulations by women throughout their reproductive life has given rise to concerns about the effects of oral contraceptives on risk factors for coronary heart disease. Oral contraceptive-induced changes in both carbohydrate and lipoprotein risk factors may contribute to an increased risk of coronary heart disease. Carbohydrate and lipoprotein risk factors for coronary heart disease are reviewed, and oral contraceptive-induced changes in carbohydrate and lipoprotein metabolism, which may lead to altered risk status for coronary heart disease, are discussed. The importance of methodology in evaluating the results of studies assessing such oral contraceptive-induced changes is stressed. The role of progestins in influencing coronary heart disease risk factors is surveyed, and differences among progestins commonly used in oral contraceptive formulations are discussed. In addition, the effect of various combination oral contraceptives on risk factor status is outlined. Finally, the implications of available evidence for the selection of progestins for oral contraceptive formulations of the future are discussed. Current data indicate that medium- and low-fixed-dose oral contraceptive formulations containing estrogen/norethindrone acetate have less metabolic impact than do comparable levonorgestrel-containing formulations, including multiphasic formulations. Triphasic formulations may have less effect on coronary heart disease risk factors, although data are not yet conclusive. Novel progestins such as desogestrel may also have lesser effects on metabolic functions, but the reduced androgenicity of such compounds may expose women to an increased risk of estrogen-induced hypertriglyceridemia.

Authors+Show Affiliations

Cavendish Clinic, London, England.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

3287933

Citation

Crook, D, et al. "Oral Contraceptives and Coronary Heart Disease: Modulation of Glucose Tolerance and Plasma Lipid Risk Factors By Progestins." American Journal of Obstetrics and Gynecology, vol. 158, no. 6 Pt 2, 1988, pp. 1612-20.
Crook D, Godsland IF, Wynn V. Oral contraceptives and coronary heart disease: modulation of glucose tolerance and plasma lipid risk factors by progestins. Am J Obstet Gynecol. 1988;158(6 Pt 2):1612-20.
Crook, D., Godsland, I. F., & Wynn, V. (1988). Oral contraceptives and coronary heart disease: modulation of glucose tolerance and plasma lipid risk factors by progestins. American Journal of Obstetrics and Gynecology, 158(6 Pt 2), 1612-20.
Crook D, Godsland IF, Wynn V. Oral Contraceptives and Coronary Heart Disease: Modulation of Glucose Tolerance and Plasma Lipid Risk Factors By Progestins. Am J Obstet Gynecol. 1988;158(6 Pt 2):1612-20. PubMed PMID: 3287933.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral contraceptives and coronary heart disease: modulation of glucose tolerance and plasma lipid risk factors by progestins. AU - Crook,D, AU - Godsland,I F, AU - Wynn,V, PY - 1988/6/1/pubmed PY - 1988/6/1/medline PY - 1988/6/1/entrez KW - Androgens KW - Arterial Occlusive Diseases KW - Arteriosclerosis KW - Atherosclerosis KW - Biology KW - Carbohydrate Metabolic Effects KW - Cardiovascular Effects KW - Contraception KW - Contraceptive Agents KW - Contraceptive Agents, Female KW - Contraceptive Agents, Progestin KW - Contraceptive Methods KW - Diabetes Mellitus KW - Diseases KW - Endocrine Effects KW - Endocrine System KW - Estrogens KW - Family Planning KW - Glucose Metabolism Effects KW - Heart Diseases KW - Hormones KW - Levonorgestrel KW - Lipid Metabolic Effects KW - Lipids KW - Literature Review KW - Metabolic Effects KW - Oral Contraceptives KW - Oral Contraceptives, Combined KW - Oral Contraceptives, Low-dose KW - Oral Contraceptives, Phasic KW - Physiology KW - Risk Factors KW - Vascular Diseases SP - 1612 EP - 20 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 158 IS - 6 Pt 2 N2 - Widespread use of oral contraceptive formulations by women throughout their reproductive life has given rise to concerns about the effects of oral contraceptives on risk factors for coronary heart disease. Oral contraceptive-induced changes in both carbohydrate and lipoprotein risk factors may contribute to an increased risk of coronary heart disease. Carbohydrate and lipoprotein risk factors for coronary heart disease are reviewed, and oral contraceptive-induced changes in carbohydrate and lipoprotein metabolism, which may lead to altered risk status for coronary heart disease, are discussed. The importance of methodology in evaluating the results of studies assessing such oral contraceptive-induced changes is stressed. The role of progestins in influencing coronary heart disease risk factors is surveyed, and differences among progestins commonly used in oral contraceptive formulations are discussed. In addition, the effect of various combination oral contraceptives on risk factor status is outlined. Finally, the implications of available evidence for the selection of progestins for oral contraceptive formulations of the future are discussed. Current data indicate that medium- and low-fixed-dose oral contraceptive formulations containing estrogen/norethindrone acetate have less metabolic impact than do comparable levonorgestrel-containing formulations, including multiphasic formulations. Triphasic formulations may have less effect on coronary heart disease risk factors, although data are not yet conclusive. Novel progestins such as desogestrel may also have lesser effects on metabolic functions, but the reduced androgenicity of such compounds may expose women to an increased risk of estrogen-induced hypertriglyceridemia. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/3287933/Oral_contraceptives_and_coronary_heart_disease:_modulation_of_glucose_tolerance_and_plasma_lipid_risk_factors_by_progestins_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0002-9378(88)90199-8 DB - PRIME DP - Unbound Medicine ER -