Progestogens and cardiovascular disease. A critical review.
Although progestational hormones are clearly beneficial in preventing estrogen-induced endometrial hyperplasia and cancer, their effect on other areas is far less clear. Of particular interest is the attenuating effect medroxyprogesterone acetate (MPA) has on the cardiovascular benefits of postmenopausal estrogen treatment. MPA reduces the dilatory effect of estrogens on coronary arteries, increases the progression of coronary artery atherosclerosis, accelerates low-density lipoprotein uptake in plaque, increases the thrombogenic potential of atherosclerotic plaques and promotes insulin resistance and its consequent hyperglycemia. These effects may be largely limited to MPA and not shared with other progestogens.
Clarkson
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Comparative Medicine Clinical Research Center, Wake Forest University School of Medicine, Medicine Center Boulevard, Winston-Salem, NC 27157-1040, USA.
D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000503:physiopathology; D018450:Disease Progression; D004967:Estrogens / Q000494:pharmacology; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia; D007333:Insulin Resistance; D008077:Lipoproteins, LDL / Q000097:blood / Q000378:metabolism; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects* / Q000494:pharmacology; D045167:Progesterone Congeners / Q000009:adverse effects* / Q000494:pharmacology; D011372:Progestins / Q000009:adverse effects / Q000494:pharmacology*
D004967:Estrogens; D008077:Lipoproteins, LDL; D045167:Progesterone Congeners; D011372:Progestins; D017258:Medroxyprogesterone Acetate