A Prospective Study of Past Use of Oral Contraceptive Agents and Risk of Cardiovascular Diseases

Stampfer, Meri J.; Willett, Walter C.; Colditz, Graham A.; Speizer, Frank E.; Hennekens, Charles H.

doi:10.2307/1966576

Cited by 28 publications

(62 citation statements)

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“…Recent studies have indicated that CRP levels are raised during use of COCs [9,10]. However, the return to normal of coagulation abnormalities after discontinuing the pill and the fact that past users of oral contraceptives have no increased risk of myocardial infarction supports the view that COCs influence the risk of CVD through prothrombotic rather than proatherogenic mechanisms [11].…”

Section: Introductionmentioning

confidence: 99%

Treatment with combined oral contraceptives induces a rise in serum C‐reactive protein in the absence of a general inflammatory response

Rooijen

Hansson

Frostegård

et al. 2006

Journal of Thrombosis and Haemostasis

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Summary. Background: The role of inflammation in the pathogenesis of cardiovascular disease is well established. C-reactive protein (CRP) is the strongest independent predictor of myocardial infarction and stroke in women. Recent studies have indicated that CRP levels are raised during use of combined oral contraceptives (COCs). Objectives: The aim of the study was to investigate the effect of COCs on serum CRP levels and to indicate the underlying mechanisms of an expected increase. Method: In a prospective randomized cross overstudy 35 women used two different preparations of COC, one second and one third generation. Serum levels of CRP, serum amyloid A (SAA), interleukin-6 (IL-6), tumor necrosis factor a (TNFa), antibodies against oxidized LDL, insulin and insulinlike growth factor-I (IGF-I) along with insulin-like growth factor binding protein-1 (IGFBP-1) and IGFBP-3 were analyzed before and during the two treatments. E-selectin, von Willebrand factor and factor VIII concentrations in plasma were also measured. Results: A rise in serum CRP was observed during both treatments; the median level increased from 0.45 mg L )1 at baseline to 1.48 mg L )1 with second generation and to 2.02 mg L )1 with third generation COC. The serum levels of SAA increased slightly during treatment with the third generation COC. IL-6 and TNFa were unaffected by treatment. Both preparations lowered IGF-I and raised IGFBP-1 and IGFBP-3 concentrations. Conclusion: The raised serum CRP concentration during treatment with COCs appears to be related to a direct effect on hepatocyte CRP synthesis and does not reflect IL-6 mediated inflammation, endothelial activation or induction of insulin resistance.

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Section: Introductionmentioning

confidence: 99%

Treatment with combined oral contraceptives induces a rise in serum C‐reactive protein in the absence of a general inflammatory response

Rooijen

Hansson

Frostegård

et al. 2006

Journal of Thrombosis and Haemostasis

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“…Epidemiological studies regarding the association between stroke and OCs use led to conflicting results. [2][3][4][5][6][7][8][9] However, recent meta-analysis concluded that the current use of lowdose OC increased the overall risk of stroke by 2-fold compared with nonuse. 10 -13 This association increased in presence of migraine, high blood pressure, or smoking.…”

mentioning

confidence: 99%

Progestogen-Only Contraceptives and the Risk of Stroke

Chakhtoura

Canonico

Gompel

et al. 2009

Stroke

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Background and Purpose-The association between combined oral contraceptives (OC) use and increased risk of stroke has been reported. While progestogen-only contraceptives (POC) are commonly used worldwide, their impact on cardiovascular disease remains unclear. Methods-A meta-analysis based on EMBASE and MEDLINE referenced literature corresponding to OCs marketed since 1960 was carried out. Eligible articles assessing the risk of stroke in relation to OC or POC were reviewed, and relevant studies were extracted. All types of POC and routes of administration were taken into account in the meta-analysis. Results-Six case-control studies were identified. The combined odd ratio (OR) showed no increase in the risk of stroke among POC users (ORϭ0.96; 95% confidence interval: 0.70 to 1.31). This result was similar according to the route of administration (either implant or injectable or oral POC). Conclusion-Data from observational studies show that POC use is not associated with an increased risk of stroke.However, these results are based on limited data. Further investigations are needed in women with risk factors of stroke.

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“…Reports of negative effects of OCs on circulating lipoproteins plus early studies associating cardiovascular disease (CVD) with OCs (using hormone doses that are no longer prescribed), led to concern that OC use might be associated with increased risk of coronary disease. However, longterm follow-up of women who reported taking OCs as long as 15 years before does not indicate any increase in the relative risk of CVD with past OC use, despite negative effects on circulating lipoproteins [31].…”

Section: Exogenous Gonadal Hormonesmentioning

confidence: 80%