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Query: UMLS:C0020473 (hyperlipidemia)
 15,891 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This summary of management of pill patients covers contraindications, individualizing pill formulations for normal women, and for diabetics, hypertensives, hyperlipidemics and those with personal or familial history of thrombophebitic or vascular disorders. The estrogen or progestagen balance of a pill can be selected to suit the individual. All patients beginning oral contraception should have pelvic exam, breast exam, cervical smear, fasting blood glucose, hematology and SMA-12, repeated in 3 months and yearly thereafter. Normally the pill causes transitory deterioration in glucose tolerance, increased growth hormone, a permanent change in insulin response, effects that are irreversible in 20% of users. Prediabetics should be given sequentials; diabetics should be followed weekly or monthly during oral contraception. Severe hypertension occurs in about 1% of pill users, but the risk is 4 times higher in women who had hypertension in pregnancy. Patients with increased personal or familial risk should be checked every 3 months and pills stopped immediately if blood pressure exceeds 150/100. In pill users cholesterol and free fatty acids remain normal, but lipoproteins, lecithins and triglycerides increase after 6 weeks to a plateau by 6-18 months, in proportion to estrogen dose. Since patients normally only discover hyperlipidemia after a clinical event such as xanthoma or vascular accident, those with related familial or personal history should have blood lipid studies every 3 months, and be given a progestagen only pill. Adolescents who are at high risk of pregnancy should receive progestagen or sequential pills, if their growth, bone age, hypothalamic function and reproductive organs are mature. The risk of idiopathic or posttraumatic thromboembolism is 3-9 times higher in pill users than in the normal population, but the only way of testing for risk in an individual is to do a detailed series of coagulation tests. Those predisposed should be given progestagen only or low dose pills.
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PMID:[Program of surveillance of patients under oral contraceptives]. 122 Jan 2

The interim results of a case-control study of myocardial infarction in women below age 55 years conducted in northern Italy since January 1983 are presented, based on 168 cases of acute myocardial infarction and 251 hospital controls. Cigarette smoking was strongly related to myocardial infarction, with risk estimates elevated more than 10-fold for heavy (more than 25 cigarettes per day) smokers. Smoking-related relative risks were of similar magnitude in younger (less than 45 years) and in perimenopausal (45-54 years) women and were largely unaffected by allowance for several potential distorting factors. Other factors independently and strongly related to the risk of myocardial infarction were diabetes, hypertension, and history of coronary heart disease in more than one first-degree relative. Relative risks were also elevated in women who gave birth to their first child earlier (below age 20 years) and in oral contraceptive users. However, these estimates were not significant. The apparent positive associations with clinical history of hyperlipidemia, hypertension in pregnancy, and heavy coffee consumption could be explained largely in terms of confounding, but the protection conveyed by moderate alcohol consumption remained after multivariate analysis. Thus, the interim results of this investigation in a low incidence population confirm the importance of several risk factors previously described in data collected in Northern Europe and the United States. Furthermore, possibly because of the low baseline risk, the proportion of cases attributable to smoking in middle-aged women in this population may be even larger than that previously reported from higher incidence areas.
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PMID:Risk factors for myocardial infarction in young women. 356 57

Maternal pre-pregnancy obesity is a risk factor for pre-eclampsia (proteinuric hypertension in pregnancy) among North American and European women. We studied the relationship between maternal obesity and risk of pre-eclampsia among Zimbabwean women. A case-control study was conducted at Harare Maternity Hospital, Harare, Zimbabwe, between June 1995 and April 1996. Study participants were 144 women with pre-eclampsia and 194 normotensive women serving as controls. Maternal weight, height and mid-arm circumference were measured and recorded during study participants' postpartum hospital admission. Maternal mid-arm circumference, considered to be relatively stable during pregnancy among women of developing countries, was used as the primary indicator of maternal pre-pregnancy obesity. Logistic regression procedures were used to estimate odds ratios and 95% confidence intervals. There were linear trends in risk of pre-eclampsia with increasing mid-arm circumference, increasing weight and increasing body mass index. After adjusting for potential confounding factors, women in the highest quintile for mid-arm circumference (28-39 cm) were 4.4 times more likely to have had their pregnancy complicated by pre-eclampsia than women in the lowest quintile (21-23 cm). Odds ratios of similar magnitude were observed for the other anthropometric measures. To our knowledge, this is the first study to demonstrate a positive association between maternal obesity and pre-eclampsia risk in a black African population. Biological mechanisms thought to explain this relatively consistent epidemiological finding include endothelial cell injury, possibly resulting from hyperlipidaemia.
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PMID:Risk factors for pre-eclampsia among Zimbabwean women: maternal arm circumference and other anthropometric measures of obesity. 969 Feb 61