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Reduced high-density lipoprotein in women aged 40-41 using oral contraceptives. Consultation Bureau Heart Project
Insights
Women using oral contraceptives and smoking had significantly lower high-density-lipoprotein (HDL) cholesterol levels. This finding is concerning as low HDL cholesterol is a major risk factor for coronary heart disease (CHD).
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Coronary heart disease (CHD) remains a leading cause of mortality.
- High-density-lipoprotein (HDL) cholesterol is a key indicator of cardiovascular health.
- Understanding risk factors influencing HDL cholesterol is crucial for prevention strategies.
Purpose of the Study:
- To investigate risk factors associated with serum HDL cholesterol levels in a young adult population.
- To examine the impact of oral contraceptive use and smoking on HDL cholesterol in women.
- To assess the relationship between HDL cholesterol and other cardiovascular risk factors.
Main Methods:
- Cross-sectional survey of 40-41 year olds in Leiden.
- Measurement of serum HDL cholesterol concentrations.
- Statistical analysis to identify associations with demographic and lifestyle factors.
Main Results:
- Mean HDL cholesterol was higher in women (47.94 mg/dl) than men (42.40 mg/dl).
- No association found between HDL cholesterol and blood pressure, obesity, or ECG changes.
- Cigarette smoking and oral contraceptive use were strongly linked to reduced HDL cholesterol in women.
- Women using oral contraceptives who also smoked had the lowest HDL cholesterol levels (43.0 mg/dl), similar to men (42.4 mg/dl).
Conclusions:
- Oral contraceptive use and smoking synergistically reduce HDL cholesterol in women.
- Low HDL cholesterol in women using oral contraceptives and smoking poses a significant CHD risk.
- Further research is warranted on the cardiovascular implications of oral contraceptive use, particularly in smokers.
Abstract:
In a survey of risk factors for coronary heart-disease (C.H.D.) in a Leiden population aged 40-41 years, mean serum-high-density-lipoprotein (H.D.L.)-cholesterol was significantly higher in 447 women (47.94 mg/dl) than in 471 men (42.40 mg/dl). No association was found between serum-H.D.L.-cholesterol and systolic or diastolic blood-pressure, obesity, or electrocardiographic changes. Cigarette smoking with use of oral contraceptives were strongly associated with reduced serum-H.D.L.-cholesterol. The difference in mean serum-H.D.L.-cholesterol concentrations between women who were on oral contraceptives and those who were not was independent of the effect of smoking. The finding of a low mean serum-H.D.L.-cholesterol concentration in pill users who smoke (i.e., similar to that in men of the same age; 43.0 mg/dl and 42.4 mg/dl in women and men, respectively) is disturbing since low serum-H.D.L.-cholesterol is a major C.H.D. risk factor and because of the reported increase in mortality from circulatory diseases in women using oral contraceptives.