Blood pressure, serum total cholesterol and contraceptive pill use in 17-year-old girls

Nawrot, Tim S.; Hond, Elly Den; Fagard, Robert; Hoppenbrouwers, Karel; Staessen, Jan A.

doi:10.1097/01.hjr.0000103463.31435.1e

Cited by 24 publications

(18 citation statements)

References 24 publications

(26 reference statements)

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“…Although recent cross-sectional studies found an association between COCs and mild BP elevations,(11, 13) these findings were not confirmed in our longitudinal cohort. Although compared with controls a slightly higher proportion of COC-users had an increase in weight of 10 or more pounds at 6 and 12 months, these differences were not statistically significant.…”

Section: Discussioncontrasting

confidence: 99%

“…Among 120 adolescents in Belgium, COC-users had average SBP that was 4.6 mmHg higher than non-users. (11) A second study of more than 2000 adolescents in Germany reported that COC-use was associated with a small but statistically significant increase in systolic BP, with a mean of 115.2 mmHG in COC-users versus 113.6 in non-users. (12) A study of more than 1200 Australian youth reported that COC-users had higher SBP (3.3 mmHg) and diastolic blood pressure (DBP), (1.7 mmHG) than non-users.…”

mentioning

confidence: 99%

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Initiation of Oral Contraceptives and Changes in Blood Pressure and Body Mass Index in Healthy Adolescents

Kharbanda

Parker

Sinaiko

et al. 2014

The Journal of Pediatrics

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Objectives To describe changes in systolic blood pressure (SBP), diastolic blood pressure (DBP) and body mass index (BMI) associated with initiation and continued use of combined oral contraceptives (COCs) in healthy adolescents. Study design This observational, matched cohort study was conducted in two large health systems. Utilizing claims and electronic medical records, we identified adolescents 14-17.9 years of age initiating medium-dose COCs (containing 30 or 35 micrograms of ethinyl estradiol or equivalent and a progestin) between 7/1/07-12/31/09 with a baseline and at least one follow-up BP and BMI. COC-users were matched 1:2 by age, race/ethnicity and site to controls (COC-non-users). All BPs and BMIs recorded during outpatient visits starting 1 month prior to COC initiation (index date for controls), through 12/31/2010 were collected. Mixed model linear regression with random intercepts and slopes were then used to estimate changes in SBP, DBP and BMI over time. Results The 510 adolescent COC-users and 912 controls did not differ significantly by age, race/ethnicity, insurance, baseline SBP, DBP or BMI. After adjusting for baseline values, over a median of 18 months follow-up, COC-users had an decrease in SBP of 0.07 mmHG/month, and controls had an increase of 0.02 mmHG/month (p=.65). Similarly, DBP decreased by 0.007 mmHG/month in COC-users versus 0.006 mmHG/month in controls (p=.99). BMI increased by 0.04 (kg/m2)/month in COC-users versus 0.025(kg/m2)/month in controls (p=.09). Conclusions These data should provide reassurance to patients and providers regarding the lack of significant associations between COC-use and BMI or BP changes in adolescents.

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Section: Discussioncontrasting

confidence: 99%

mentioning

confidence: 99%

Initiation of Oral Contraceptives and Changes in Blood Pressure and Body Mass Index in Healthy Adolescents

Kharbanda

Parker

Sinaiko

et al. 2014

The Journal of Pediatrics

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“…18 The 30% of our female adolescents who reported taking OC had significantly increased SBP and DBP, as compared with non-OC users. These data agree with results from a study of 17-year-old girls that shows a 4.6 mmHg higher SBP in low-dose OC users, 19 which suggests a marked pressor effect of OC in adolescence. Data are presented as mean (95% confidence interval), or for categorical variable as percentage (95% confidence interval) or n (%) as indicated; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; HDL-C: high density lipoprotein cholesterol; LDL-C: low density lipoprotein cholesterol; *Gender-specific SBP or DBP !…”

Section: Discussionsupporting

confidence: 90%

Oral contraceptive use in girls and alcohol consumption in boys are associated with increased blood pressure in late adolescence

Le-Ha

Beilin

Burrows

et al. 2012

Eur J Prev Cardiolog

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Aims: Lifestyle behaviours established during adolescence may adversely affect blood pressure (BP) and contribute to gender differences in cardiovascular risk in adulthood. We aimed to assess the association of health behaviours with BP in adolescents, using data from the Western Australian Pregnancy (Raine) Study. Methods: Cross-sectional analysis on 1248 Raine Study adolescents aged 17 years, to examine associations between lifestyle factors and BP. Results: Boys had 8.97 mmHg higher systolic BP, as compared with girls. The 30% of girls using oral contraceptives (OC) had 3.27 and 1.74 mmHg higher systolic and diastolic BP, respectively, compared with non-users. Alcohol consumption in boys, increasing body mass index (BMI) and the sodium-potassium ratio were associated with systolic BP. We found a continuous relationship between BMI and systolic BP in both genders; however, the gradient of this relationship was significantly steeper in boys, compared with girls not taking OC. In boys, systolic BP was 5.7 mmHg greater in alcohol consumers who were in the upper quartile of BMI and the urinary sodium-potassium ratio compared with teetotallers in the lowest quartile. In girls, systolic BP was 5.5 mmHg higher in those taking OC, in the highest BMI and urinary sodiumpotassium ratio quartile as compared to those not taking the OC pill and in the lowest quartile. Conclusion: In addition to gender-related differences in the effects of adiposity on BP, we found lifestyle-related health behaviours such as high salt intake for both sexes, consumption of alcohol in boys, and OC use in girls were important factors associated with BP measurements in late adolescence. This suggests that gender-specific behavioural modification in adolescence may prevent adult hypertension.

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“…Clustering of behavioral cardiovascular risk factors among adolescents has been previously observed to be associated with an adverse biological cardiovascular risk profile [13]. Previous studies conducted among adolescents reported an association of HC use and elevated SBP, DBP, serum total cholesterol and LDL-C [11,[13][14][15][16]. Studies that were conducted in the 1970s and 1980s found decreased HDL-C levels among HC users as compared with nonusers [16,30].…”

Section: Discussionmentioning

confidence: 99%

“…Events such as venous thrombosis, stroke, and myocardial infarction occur rarely in adolescents, thus, hard endpoint studies would require extended follow-up far into adulthood. Previous epidemiological studies on HCs and cardiovascular risk in adolescents focused on behavioral risk factors relevant to cardiovascular risk or surrogate endpoints, such as blood pressure and serum lipids [11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Hormonal Contraceptive Use Among Adolescent Girls in Germany in Relation to Health Behavior and Biological Cardiovascular Risk Factors

Rosner

Knopf

et al. 2011

Journal of Adolescent Health

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RESULTSHC users were more likely than nonusers to combine several behavior-related health risks, independent of sociodemographic factors. In particular, HC use was strongly associated with current smoking (odds ratio: 3.4, 95% confidence interval: 2.7-4.3). HC use and behavioral factors showed an additive effect on biological cardiovascular risk factors, explaining between 6% and 30% of the population variance. Relative contributions of HC use ranged from <1% for systolic and diastolic blood pressure to 12% for hs-CRP. CONCLUSIONSHC use among 13-17-year old girls in Germany is significantly correlated with a more unfavorable cardiovascular risk profile, which is partly explained by a clustering of behavioral risk factors among HC users. When prescribing HC to teenagers, physicians should 2 systematically assess avoidable behavioral cardiovascular risk factors and provide counseling tailored to the risk profile of the individual patient.

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Blood pressure, serum total cholesterol and contraceptive pill use in 17-year-old girls

Abstract: In 17-year-old girls, the use of oral contraceptives was associated with a nearly 5 mmHg higher systolic blood pressure and a 0.4 mmol/l higher level of serum total cholesterol. The long-term prognostic implications of our findings remain to be elucidated.

Cited by 24 publications

References 24 publications

Initiation of Oral Contraceptives and Changes in Blood Pressure and Body Mass Index in Healthy Adolescents

Initiation of Oral Contraceptives and Changes in Blood Pressure and Body Mass Index in Healthy Adolescents

Oral contraceptive use in girls and alcohol consumption in boys are associated with increased blood pressure in late adolescence

Hormonal Contraceptive Use Among Adolescent Girls in Germany in Relation to Health Behavior and Biological Cardiovascular Risk Factors

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