Coronary Artery Disease and Progesterone

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To the editor: We were intrigued by the results of Gordon and co-workers indicating protection against coronary artery disease in premenopausal women (Ann Intern Med 89:157–161, 1978). Although most attempts to explain this phenomenon have been centered on possible estrogen-induced changes in atherogenic factors such as lipid metabolism, we believe that this protection is due to other frequently overlooked factors.

In our laboratory we have observed that coronary arteries of isolated rat hearts constrict after about 20 minutes of hypoxic perfusion following an initial dilating response (1). In the presence of physiologic levels of progesterone, however, this constrictor response was

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