[Hormonal contraceptives and high blood pressure (author's transl)]

The aim of this report is to offer an explanation for the high incidence of arterial hypertension in women taken hormone contraceptives. The real incidence of this association has been considered in women initially having a normal blood pressure and in others who had high blood pressure before using these contraceptives. The estrogen and progestogen components in hormone contraceptives were analyzed individually in various studies. The most recent investigations seem to indicate that progestogen is the main cause of high blood pressure. Different mechanism that could link hormone contraceptives to high blood pressure were investigated. The renin-angiotensin-aldosterone axis involving the action of estrogens and progestogens on the renin substrate, plasma renin, angiotensin II and aldosterone were analyzed. Another possible mechanism could involve glucocorticoids, altering the metabolism of glucose, pyruvate, cholesterol, and triglycerides, Kidney disease involving renal function, microangiopathic anemia, and renal thromboembolism; hyperactivity of the sympathetic nervous system (noraepinephrine and dopamine-beta-hidroxylase blood levels); prostaglandins; genetic mechanism; and individual mechanism were all taken into consideration. Lastly the priorities of the different systems linking high blood pressure to hormone contraceptives and the relationships between them are analyzed.