Cardiovascular disease: pathogenesis, epidemiology, and risk among users of oral contraceptives who smoke.
Am J Obstet Gynecol
; 180(6 Pt 2): S349-56, 1999 Jun.
Article
en En
| MEDLINE
| ID: mdl-10368520
ABSTRACT
PIP: This paper examines the pathogenesis, epidemiology and risk of cardiovascular disease due to smoking and oral contraceptive (OC) use among women. The major risks associated with smoking were cardiovascular diseases and lung cancer. Characteristics of a syndrome which significantly increases the cardiovascular disease risk include: waist/hip girth ratio 0.8, glucose concentration 100 mg/dl, insulin 25 mU/l, peptide C 1.3 nmol/l, blood pressure 135/85 mm Hg, high triglyceride level 150 mg/dl with low concentration of HDL cholesterol (45 mg/d), total cholesterol/HDL ratio 4.0, LDL cholesterol (small dense pattern B) 130 mg/dl, uric acid concentration 7 mg/dl, and microalbuminuria 30-200 mg/dl. Women users over age 35 carrying the coagulation factor V Leiden mutation were found to be at increased risk of death from cardiovascular disease. The study indicates that increasing the estrogen dosage in an OC from 20 to 50 mcg ethinyl estradiol produced greater risks. Most cardiovascular disease among OC users is due to thrombosis. OCs containing the third-generation progestins desogestrel and gestodene have been associated with greater risks of venous thromboembolism that are associated with older progestins, although there is some controversy surrounding these findings. Smokers must be discouraged. When middle-aged women stopped smoking, about a third of their excess risk for coronary heart disease was eliminated within 2 years of cessation, and their risk became similar to that of nonsmoking women within 10-14 years.
Palabras clave
Americas; Behavior; Biology; Cancer--women; Cardiovascular Effects--etiology; Cardiovascular Effects--women; Contraception; Contraceptive Methods; Developed Countries; Diseases; Embolism; Epidemiology; Family Planning; Health; Literature Review; Massachusetts; Neoplasms; North America; Northern America; Oral Contraceptives; Physiology; Public Health; Pulmonary Effects--women; Recommendations; Risk Factors--women; Smoking--women; Thromboembolism--women; United States; Vascular Diseases; Women
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedades Cardiovasculares
/
Fumar
/
Anticonceptivos Orales
Tipo de estudio:
Etiology_studies
/
Screening_studies
Límite:
Female
/
Humans
Idioma:
En
Revista:
Am J Obstet Gynecol
Año:
1999
Tipo del documento:
Article
País de afiliación:
Estados Unidos
Pais de publicación:
Estados Unidos