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Renin-Angiotensin-Aldosterone System in Women Using Combined Oral Contraceptive: A Systematic Review
Priscilla Araújo Dos Santos1, Alice Miranda de Oliveira2, Caroline Queiroz Alves3
1Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.
Summary
Combined oral contraceptives (COC) significantly activate the renin-angiotensin-aldosterone system (RAAS). This suggests a potential link between COC use and increased cardiovascular risks, such as hypertension.
Area of Science:
- Cardiovascular Pharmacology
- Endocrinology
- Reproductive Health
Background:
- Combined oral contraceptives (COC) are widely used for contraception.
- The renin-angiotensin-aldosterone system (RAAS) plays a crucial role in blood pressure regulation.
- Understanding COC's impact on RAAS is vital for assessing cardiovascular risks.
Purpose of the Study:
- To systematically review the effects of combined oral contraceptives (COC) on the renin-angiotensin-aldosterone system (RAAS).
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searches conducted in Medline, Cochrane Library, SciELO, and LILACS databases.
- Included 10 studies from 877 initially identified, analyzing RAAS components.
Main Results:
- Analysis of 501 women aged 18-49 years across included studies.
- Consistent findings of increased plasma renin activity, angiotensinogen, angiotensin II, and aldosterone.
- COC use was associated with heightened RAAS activation.
Conclusions:
- Combined oral contraceptives (COC) appear to enhance RAAS activity.
- This activation may contribute to an elevated risk of cardiovascular events.
- Potential association with increased incidence of systemic arterial hypertension.
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