2007
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Topics
oral contraceptives cardiovascular risk AHA statement, American Heart Association oral contraceptive cardiovascular disease, birth control pill cardiovascular risk women, hormonal contraception heart disease stroke risk, oral contraceptive venous thromboembolism cardiovascular events, combined oral contraceptive cardiovascular safety, oral contraceptive blood pressure hypertension risk, hormonal contraception arterial venous thrombosis risk
Cite this article
American Heart Association (2007). Oral Contraceptives and Cardiovascular Risk (AHA Abstract).
American Heart Association. Oral Contraceptives and Cardiovascular Risk (AHA Abstract). 2007.
American Heart Association. Oral Contraceptives and Cardiovascular Risk (AHA Abstract). 2007.
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Risk of venous thrombosis with use of current low-dose oral contraceptives is not explained by diagnostic suspicion and referral bias
Bloemenkamp KW et al., 1999·Arch Intern Med
The magnitude of the relative risk of venous thrombosis caused by low-dose oral contraceptive use is still debated because previous studies might have been affected by diagnostic suspicion and referral bias. We conducted a case-control study in which the effect of diagnostic suspicion and referral bias was excluded. The study was performed in 2 diagnostic centers to which patients with clinically suspected deep vein thrombosis of the leg were referred. History of oral contraceptive use was obtained before objective testing for thrombosis. Young females with an objective diagnosis of deep vein thrombosis were considered case patients, and those who were referred with the same clinical suspicion but who had no thrombosis served as control subjects. Participants were seen between September 1, 1982, and October 18, 1995: 185 consecutive patients and 591 controls aged 15 to 49 years with a first episode of venous thrombosis and without malignant neoplasms, pregnancy, or known inherited clotting defects. The overall odds ratio for oral contraceptive use was 3.2 (95% confidence interval [CI], 2.3-4.5); after adjustment for age, family history of venous thrombosis, calendar time, and center, the odds ratio was 3.9 (95% CI, 2.6-5.7). In the idiopathic group (120 patients and 413 controls, excluding recent surgery, trauma, or immobilization), the odds ratio for oral contraceptive use was 3.8 (95% CI, 2.5-5.9); after adjustment, the odds ratio was 5.0 (95% CI, 3.1-8.2). In this study, in which patients and controls were subj ect to the same referral and diagnostic procedures, we found similar relative risk estimates for oral contraceptive use as in previous studies. We conclude that diagnostic suspicion and referral bias did not play an important role in previous studies and that the risk of venous thrombosis with use of current brands of oral contraceptives still exists.
Contraception/ComparisonCardiovascular RiskAtherosclerosis PathogenesisCell Proliferation Assays
Atherosclerosis and oral contraceptive use. Serum from oral contraceptive users stimulates growth of arterial smooth muscle cells
Bagdade JD et al., 1982·Arteriosclerosis
Pooled serum from women taking a combined estrogen-progestin oral contraceptive preparation caused significantly greater cell proliferation and incorporation of 3H-thymidine into DNA in both human arterial smooth muscle cells and dermal fibroblasts in tissue culture than did serum from controls. A portion of this mitogenic effect appears to be related to the presence of a factor(s) that is heat stable, nondialyzable, and contained in the lipoprotein-deficient serum fraction. In vitro addition of varying concentrations of mestranol and norethindrone, the two constituents of the oral contraceptive preparation taken by participants in the study, to control serum did not enhance its mitogenicity, suggesting that the effect observed with intact serum was due either to a metabolite of these compounds or to the production of other growth-promoting substances during oral contraceptive treatment. Since smooth muscle cell proliferation is an integral feature of all atherosclerotic lesions, these findings provide some insights applicable to understanding the pathogenesis of vascular disease associated with oral contraceptive use.