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Related Experiment Videos

Cardiovascular risks: perception versus reality.

D R Mishell1

  • 1Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles 90033, USA.

Contraception
|May 26, 1999
PubMed
Summary
This summary is machine-generated.

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Current low-estrogen oral contraceptives (OC) show no increased risk for heart attack or stroke in healthy, nonsmoking women. However, they carry a higher risk of venous thromboembolism (VTE), comparable to pregnancy.

Area of Science:

  • Cardiovascular Health
  • Reproductive Endocrinology
  • Pharmacology

Background:

  • Original oral contraceptives (OC) contained high estrogen doses, linked to increased cardiovascular event risks.
  • Steroid doses in OCs have been progressively reduced, leading to current low-estrogen formulations (< or = 35 micrograms).

Purpose of the Study:

  • To evaluate the cardiovascular disease risks associated with current low-dose OC use in healthy, nonsmoking women.
  • To compare risks between different OC formulations and with pregnancy and smoking.

Main Methods:

  • Epidemiological evidence review.
  • Analysis of cardiovascular event risks (myocardial infarction, stroke, venous thromboembolism) associated with low-dose OC use.

Main Results:

Related Experiment Videos

  • Low-dose OCs (< or = 35 micrograms estrogen) are not associated with increased risk of myocardial infarction or stroke.
  • A three- to fourfold increased risk of venous thrombosis and embolism (VTE) exists with low-dose OC use.
  • This VTE risk is approximately half the risk associated with pregnancy.

Conclusions:

  • Healthy, nonsmoking women using low-dose OCs have no elevated risk of arterial events (MI, stroke).
  • The primary risk associated with low-dose OCs is VTE, which is less than that of pregnancy.
  • Smoking is a significant independent risk factor for MI, synergistic with OC use; women over 35 who smoke should avoid estrogen-containing OCs.