Effects of contraceptive steroids on serum lipoproteins and cardiovascular disease scrutinized at workshop in Bethesda.

ABSTRACT

PIP A 2-day workshop was held at the National Institute of Health during May 1979 in an effort to assess the current status of the interrelationships between high density lipoprotein (HDL) levels and the incidence of ischemic heart disease and to delineate immediate needs for further research aimed at improved steroid contraceptive safety. Review of older and recent data gave little doubt as to the association between lipoprotein patterns and the incidence of heart disease. Less clear was the relationship between lipoprotein patterns and coronary heart disease (CHD) then is the relationship between oral contraceptive (OC) usage and lipoprotein patterns. Workshop participants did provide strong evidence that OC usage can modify these patterns. The final interrelationship discussed was that of OC usage and cardiovascular disease, particularly atherosclerosis. Along with considering the interactions among OCs, serum lipoproteins, and cardiovascular disease by epidemiologic approaches, workshop participants also considered the status of current studies bearing on the mechanisms by which these interactions may be mediated and the status of methodology for evaluating the interactions. During the general discussion at the end of the workshop, participants agreed that the apparent association between HDL levels and the incidence of cardiovascular disease dictates the need for vigorous research. It was agreed that at least some OC pills do lower serum HDL levels.^ieng