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11.07.2016 | General Gynecology

Cardiovascular disease incidence among females in South Carolina by type of oral contraceptives, 2000–2013: a retrospective cohort study

verfasst von: Marsha E. Samson, Swann A. Adams, Anwar T. Merchant, Whitney D. Maxwell, Jiajia Zhang, Charles L. Bennett, James R. Hebert

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 5/2016

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Abstract

Introduction

Certain types of oral contraceptives can produce favorable effects on lipid metabolism and vascular tone, while others have potentially detrimental effects. Endogenous and exogenous hormones exert different effects on high-density lipoprotein (HDL) and low-density lipoprotein (LDL) depending on the type, combination, and dose of the hormone. The estrogenic and progestogenic effects of exogenous hormones on HDL and LDL are inconsistent. Studying surrogate end points (LDL, HDL levels) may provide a misleading picture of OCs.

Methods

Medicaid data from 2000 to 2013 were used to assess the relationship between the type of OCs and CVD incidence. Multivariable logistic regression was used to model relationships between cardiovascular disease and OC use adjusting for potential confounders.

Results

Compared to combined oral contraceptives (COC), progestin-only oral contraceptives (POC) were associated with decreased heart disease and stroke incidence after adjusting for important covariates (OR 0.74; 95 % CI 0.57, 0.97 and OR 0.39; 95 % CI 0.16, 0.95, respectively). However, there was a positive association between POC + COC and both heart disease and stroke incidence (OR 2.28; 95 % CI 1.92, 2.70 and OR 2.12; 95 % CI 1.34, 3.35, respectively).

Conclusion

In light of an association between POC use and decreased heart disease and stroke, women’s CVD risk factors should be carefully considered when choosing which OC to use. Baseline CVD risk should be a part of the discussion between women and their primary care providers when making choices regarding OCs.

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Titel: Cardiovascular disease incidence among females in South Carolina by type of oral contraceptives, 2000–2013: a retrospective cohort study
verfasst von: Marsha E. Samson
Swann A. Adams
Anwar T. Merchant
Whitney D. Maxwell
Jiajia Zhang
Charles L. Bennett
James R. Hebert
Publikationsdatum: 11.07.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Gynecology and Obstetrics / Ausgabe 5/2016
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-016-4143-5

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Cardiovascular disease incidence among females in South Carolina by type of oral contraceptives, 2000–2013: a retrospective cohort study