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Risk factors for coronary heart disease and platelet functions.

Abstract：

:Epidemiologic studies have shown that several environmental factors are associated with coronary heart disease (CHD). Most of them are predisposing factors known also as risk factors. Other factors appear to have preventive effects. Blood lipids have been considered the main blood mediator between most of these factors and CHD. In recent years, this concept has been challenged since many of these factors did not affect serum lipids. By contrast blood platelets, involved in both thrombosis and atherosclerosis, appear to have their functions markedly changed by most of the factors associated with CHD. To determine whether saturated fats would affect platelet functions as shown in animals and in pilot studies in man, groups of male farmers (40-45 years) from 2 regions of France (Var and Moselle) in which the mortality rate from CHD differed markedly were studied, particularly regarding their platelet functions in relation to the intake of saturated fats. No difference could be observed in blood between the 2 regions concerning total cholesterol, HDL cholesterol, or triglycerides, the coagulation was markedly accelerated, as well as the platelet clotting activity in farmers from Moselle. The response of platelets mostly to thrombin but also to adenosine diphosphate (ADP), epinephrine, and collagen was more elevated in Moselle farmers. In Moselle farmers, there was significantly higher intake of saturated fats (16% of the calories) as compared to Var (12%). To determine whether the abnormal platelet response in Moselle farmers was really due to the diet or whether a genetic factor might be involved, a group of 50 Moselle farmers were persuaded to change their dietary habits in order to lower their intake of saturated fats to 10% of the calories and that of polyunsaturated to approximately 12%. 1 year after diet modification, the clotting time (PCT) and clotting activity of platelets were considerably prolonged and the response to thrombin drastically reduced. These results confirmed that the platelet functions were largely dependent upon the intake of dietary lipids. Studies in rats fed saturated fats demonstrated that addition of alcohol (6%) to the drinking water was markedly inhibiting the response of platelets to thrombin and ADP aggregation and prolonged the clotting time, despite inducing a significant hypertriglyceridemia. Several investigators have shown that platelet functions were markedly increased in diabetic patients while serum lipids were similar in the diabetic and nondiabetic subjects. Studies peformed more than 10 years ago indicated that women taking oral contraceptives (OCs) presented mostly an increase in the clotting activity of their platelets. In female rats it has been found that the administration of an OC was able, in addition to the effect of clotting, to increase the response fo platelets to thrombin and ADP induced aggregation.

journal_name

Adv Exp Med Biol

journal_title

Advances in experimental medicine and biology

authors

Renaud S

doi

10.1007/978-1-4684-8616-2_14

subject

Has Abstract

pub_date

1984-01-01 00:00:00

pages

129-44

eissn

0065-2598

issn

2214-8019

journal_volume

164

pub_type

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Risk factors for coronary heart disease and platelet functions.