A Prospective Controlled Study of the Effect on Blood Pressure of Contraceptive Preparations Containing Different Types and Dosages of Progestogen

Wilson, Elizabeth; Cruickshank, J.K.; Mcmaster, M.; Weir, R. J.

doi:10.1097/00006254-198509000-00018

Cited by 8 publications

(10 citation statements)

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“…7,8 However, higher blood pressure (BP) levels were found even in patients using monophasic pills containing 30 mg of oestrogen. 9 In a cohort study, a two-fold increase in risk for hypertension was detected in current OC users, as compared to nonusers. 10 Recently, we found that among hypertensive patients referred to a hypertension clinic, those using OC presented the highest probability of having uncontrolled BP, mainly at the expense of diastolic pressure.…”

Section: Introductionmentioning

confidence: 99%

Stopping oral contraceptives: an effective blood pressure-lowering intervention in women with hypertension

et al. 2005

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The association of combined oral contraceptives (OC) with higher blood pressure (BP) may be attenuated with pills with smaller doses of oestrogen. The effect of stopping OC on BP of patients with hypertension was not described to date. In a cohort study of patients with hypertension, we identified 72 women using OC among 2112 patients seen from 1989 to 2002. Stopping hormonal contraception was recommended to all. The main outcome measurement was BP change in women who stopped (n ¼ 44) and who did not stop (n ¼ 28) OC, adjusting for baseline BP and age. Odds ratio for having a reduction of at least 20 mmHg in systolic blood pressure (SBP) or 10 mmHg in diastolic blood pressure (DBP), adjusting for age, change in weight and prescription of BP-lowering drugs, were calculated. The mean follow-up time was 6.677.5 months. Participants who stopped and did not stop OC had similar baseline characteristics. The deltas of SBP (adjusted) were 15.172.6 mmHg in patients who stopped and 2.873.2 mmHg in patients who did not stop OC (P ¼ 0.004). The corresponding values for DBP were 10.471.8 and 2.772.2 mmHg (P ¼ 0.008), respectively. The odds ratio (adjusted) for having a decrease of at least 20 mmHg in SBP or 10 mmHg in DBP was 0.28 (95% CI 0.08-0.90) in patients who stopped OC. Stopping OC is an effective antihypertensive intervention in a clinical setting.

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Section: Introductionmentioning

confidence: 99%

Stopping oral contraceptives: an effective blood pressure-lowering intervention in women with hypertension

et al. 2005

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“…From these studies there is little evidence to suggest that contraceptive doses of progestogens given alone to normotensive premenopausal women are associated with a pressor effect on blood pressure. 31,[36][37][38] However, results of some studies have suggested that, while progestogen administered alone does not have a demonstrable pressor effect, when administered in combination with oestrogen in combined contraceptive formulations the progestogen may have a synergistic effect, thereby enhancing the pressor effect of the oestrogen. 37,39 From the currently available data a number of questions remain unanswered.…”

Section: Introductionmentioning

confidence: 99%

“…31,[36][37][38] However, results of some studies have suggested that, while progestogen administered alone does not have a demonstrable pressor effect, when administered in combination with oestrogen in combined contraceptive formulations the progestogen may have a synergistic effect, thereby enhancing the pressor effect of the oestrogen. 37,39 From the currently available data a number of questions remain unanswered. Although the results of the PEPI study were reassuring, the study did not provide information regarding the different types, doses and regimens of progestogen 'replacement' therapy currently used clinically.…”

Section: Introductionmentioning

confidence: 99%

“…The effect on blood pressure and other cardiovascular parameters of a particular oestrogen-progestogen combination may depend not only on the type and dose of the oestrogen administered, but also on the type and dose of the progestogen. 37 The magnitude of any progestogen-related effect may also be influenced by the relative androgenicity of the progestogen preparation used. [40][41][42][43][44] In the present study in normotensive postmenopausal women, a randomised, double-blind crossover design was used to compare with placebo the effects on blood pressure and other cardiovascular parameters of cyclical doses spanning the clinical dose range of the C21 progestogen, medroxyprogesterone acetate, in normotensive women receiving a fixed mid-range daily dose of conjugated equine oestrogen.…”

Section: Introductionmentioning

confidence: 99%

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Dose response effect of cyclical medroxyprogesterone on blood pressure in postmenopausal women

et al. 2001

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Objective: This study was designed to compare with placebo the dose-response effect of cyclical doses of the C21 progestogen, medroxyprogesterone acetate (MPA) on blood pressure (BP) when administered to normotensive postmenopausal women receiving a fixed mid-range daily dose of conjugated equine oestrogen (CEE). Materials and methods: Twenty normotensive postmenopausal women (median age 53 years) participated in the study which used a double-blind crossover design. There were four randomised treatment phases, each of 4 weeks duration. The four blinded treatments were MPA 2.5 mg, MPA 5 mg, MPA 10 mg and matching placebo, taken for the last 14 days of each 28 day treatment cycle. CEE 0.625 mg was also administered once daily as open labelled tablets to all subjects throughout the study. Clinic BP was measured weekly with the

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“…This paper summarises a round table panel discussion, which was part of an official symposium at the European Society of Hypertension 9th European Meeting on Hypertension held in Milan on [11][12][13][14][15] June 1999. The aim of the round table was to explore whether practising physicians understand the concepts of 'absolute' and 'relative' cardiovascular risk and also to discuss the utility of such measures in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Applying evidence-based medicine to current practice: a round table panel discussion

et al. 2000

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Over the past decade, an expanding body of epidemiological and clinical trial data has been collated, culminating in the development of guidelines designed to help physicians make decisions about intervention and the intensity of treatment, based on objective assessments of the overall level of risk for cardiovascular disease. However, guidelines are not prescriptive and allow physicians leeway in interpretation. Thus, it is of clinical interest to explore some of the issues that may influ-

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A Prospective Controlled Study of the Effect on Blood Pressure of Contraceptive Preparations Containing Different Types and Dosages of Progestogen

Cited by 8 publications

References 0 publications

Stopping oral contraceptives: an effective blood pressure-lowering intervention in women with hypertension

Stopping oral contraceptives: an effective blood pressure-lowering intervention in women with hypertension

Dose response effect of cyclical medroxyprogesterone on blood pressure in postmenopausal women

Applying evidence-based medicine to current practice: a round table panel discussion

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