Metabolic risk factors in women with premature ischemic heart disease

Total, HDL and LDL cholesterol, triglycerides, apoprotein B, some parameters of haemostasis (activity of plasminogen activator inhibitor, plasminogen, antithrombin ill, antiplasmin, fibrinogen), plasma glucose and insulin before and after oral glucose load were determined in 18 women aged 45-55 years with overt ischemic heart disease and 30 age matched apparently healthy women (spouses of men with premature coronary heart disease). There were more smokers among patients (p<0,05). Patients and controls had same proportion of menopausal women, similar systolic and diastolic blood pressures and body mass index but patients had higher waist to hip ratio (p=0,014). Average levels of total and LDL cholesterol were similar while patients had higher triglycerides (p=0,001), apoprotein B (p=0,013) and lower HDL cholesterol (p=0,001) and HDLCH/apo B ratio. There were no differences in parameters of haemostasis, basal levels of glucose and insulin. Multifactorial analysis showed that the only factor independently linked to premature ischemic heart disease was plasma level of triglycerides. Thus besides high prevalence of smoking premature ischemic heart disease in women was associated with inclination to abdominal type of body fat distribution, higher triglycerides and lower HDL cholesterol, presence of an indirect sign of preponderance of small LDL particles (lower HDLCH/apo B ratio) - i.e. factors considered to be components of the <<plurimetabolic syndrome>>. In this group of women plasma level of triglycerides was the only parameter independently related to the presence of premature ischemic heart.