[Cardiovascular risks associated with low-dose combined oral contraceptives]

The relative risk for cardiovascular events in current users of low-dosed oral contraceptives is about 2- to 3-fold greater than in nonusers. As in young women (age 20-24) the incidence for cardiovascular events is very low (51 per million woman-years) the use of modern oral contraceptives is safe in the absence of a history of smoking, hypertension, migraine, venous thromboembolism in the personal or family history and in the absence of other conventional risk factors. The cardiovascular risk is increased in women older than 35 years. This risk increases 2- to 4-fold if oral contraceptives are used and is substantially elevated in combination with additional cardiovascular risks. To minimize these risks it is essential to take a careful personal and family history and to check the blood pressure. Women with cardiovascular risks should be encouraged to use other forms of contraception, like progestagen-only methods or intrauterine devices.