Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of progestogen in vascular complications is currently being investigated. The Committee on Safety of Medicines in the United Kingdom has examined 2000 reports of vascular complications related to the hormonal content of oral contraceptives, in particular, norethisterone acetate and levonorgestrel. The 1st progestogen was combined with 50 mcg estrogen and the 2nd with 30 mcg. A significant statistical association was observed between higher doses of norethisterone acetate and death from ischemic heart disease and stroke. There was also a correlation with nonfatal events from the 2 conditions, but not with risk of hypertension or venous thrombosis. Levonorgestrel had an excess of stroke but no association with hypertension and venous thrombosis. In considering the estrogen content of the oral contraceptives, the 30 mcg estrogen had fewer deaths and less ischemic heart disease than was observed with 50 mcg estrogen. These data suggest that lowering the progestogen content of oral contraceptives should reduce the risk of arterial thromboembolism. It also reinforces the value of lower estrogen content. The risks of thromboembolism appear to be age-related, and if the risks are not acceptable to the woman who has completed her family or is over the age of 30, other well-tried alternatives should be considered. The ideal oral contraceptive is yet to be developed.
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PMID:Oral contraception and thromboembolism: the role of progestogens. 693 46