Effects of peroral hormonal contraception on cardiovascular system: analysis of selected cardiovascular parameters in an adolescent cohort; a pilot project
Language English Country Czech Republic Media print
Document type Journal Article
PubMed
36647908
PubMed Central
PMC9906664
DOI
10.33549/physiolres.934997
PII: 934997
Knihovny.cz E-resources
- MeSH
- Pulse Wave Analysis * MeSH
- Carotid Arteries MeSH
- Arterial Pressure MeSH
- Hormonal Contraception * adverse effects MeSH
- Blood Pressure physiology MeSH
- Humans MeSH
- Adolescent MeSH
- Pilot Projects MeSH
- Vascular Stiffness * physiology MeSH
- Check Tag
- Humans MeSH
- Adolescent MeSH
- Publication type
- Journal Article MeSH
Oral contraceptive pills (OCPs) have some strong advantages over more traditional types of contraception, including their consistently high contraceptive effect as well as multiple additional positive side effects. OCPs went through decades of intense pharmaceutical development and current formulas are well optimized - however, a handful of their negative side effects remain, including some that affect cardiovascular system, for example higher risk of hypertension, venous thromboembolism and increased arterial stiffness. The gold standard for arterial stiffness assessment is currently applanation tonometry, a method that relies on arterial pulse wave velocity measurement (PWV). Another possible method for arterial stiffness measurement is the use of the VaSera device, which measures cardio-ankle vascular index (CAVI). The aim of this study was to discover the effect of OCPs use on selected cardiovascular parameters related to arterial stiffness. We measured these cardiovascular parameters in the OCPs using group (OCP) and in the control group (CTRL) using applanation tonometer Sphygmocor and the VaSera device. Comparison of the data from both groups showed us significantly increased diastolic blood pressure (DBP) and carotid-radial pulse wave velocity (crPWV) as well as significantly lower subendocardial viability index (SVI) in the OCP. These results imply a negative effect of hormonal contraceptives on the cardiovascular system with most of the negative changes affecting the peripheral arteries. Despite this evidence supporting the hypothesis of OCPs having a negative effect on cardiovascular health, further research is necessary.
See more in PubMed
Information NC for B. Pike USNL of M 8600 R, MD B, Usa 20894. Contraception: Hormonal contraceptives [Internet] Inf Internet Institute for Quality and Efficiency in Health Care (IQWiG) 2017. [cited 2022 Apr 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441576/
Pletzer BA, Kerschbaum HH. 50 years of hormonal contraception-time to find out, what it does to our brain. Front Neurosci. 2014;8:256. doi: 10.3389/fnins.2014.00256. PubMed DOI PMC
United Nations. Contraceptive Use by Method 2019: Data Booklet [Internet] UN; 2019. [cited 2021 Oct 19]. Available from: https://www.un-ilibrary.org/content/books/9789210046527.
Williams NM, Randolph M, Rajabi-Estarabadi A, Keri J, Tosti A. Hormonal contraceptives and dermatology. Am J Clin Dermatol. 2021;22:69–80. doi: 10.1007/s40257-020-00557-5. PubMed DOI
Chen JT, Kotani K. Oral contraceptive therapy increases oxidative stress in pre-menopausal women. Int J Prev Med. 2012;3:893–896. doi: 10.4103/2008-7802.104862. PubMed DOI PMC
Cibula D, Gompel A, Mueck AO, La Vecchia C, Hannaford PC, Skouby SO, Zikan M, Dusek L. Hormonal contraception and risk of cancer. Hum Reprod Update. 2010;16:631–650. doi: 10.1093/humupd/dmq022. PubMed DOI
Wang Q, Würtz P, Auro K, Morin-Papunen L, Kangas AJ, Soininen P, Tiainen M, et al. Effects of hormonal contraception on systemic metabolism: cross-sectional and longitudinal evidence. Int J Epidemiol. 2016;45:1445–1457. doi: 10.1093/ije/dyw147. PubMed DOI PMC
Shufelt CL, Bairey Merz CN. Contraceptive hormone use and cardiovascular disease. J Am Coll Cardiol. 2009;53:221–231. doi: 10.1016/j.jacc.2008.09.042. PubMed DOI PMC
Hickson SS, Miles KL, McDonnell BJ, Yasmin, Cockcroft JR, Wilkinson IB, McEniery CM ENIGMA Study Investigators. Use of the oral contraceptive pill is associated with increased large artery stiffness in young women: the ENIGMA study. J Hypertens. 2011;29:1155–1159. doi: 10.1097/HJH.0b013e328346a5af. PubMed DOI
Cauci S, Xodo S, Buligan C, Colaninno C, Barbina M, Barbina G, Francescato MP. Oxidative stress is increased in combined oral contraceptives users and is positively associated with high-sensitivity C-reactive protein. Molecules. 2021;26:1070. doi: 10.3390/molecules26041070. PubMed DOI PMC
Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovasc Dis. 2012;1:cvd.2012.012016. doi: 10.1258/cvd.2012.012016. PubMed DOI PMC
Boutouyrie P, Bruno R-M. The clinical significance and application of vascular stiffness measurements. Am J Hypertens. 2019;32:4–11. doi: 10.1093/ajh/hpy145. PubMed DOI
Soska V, Frantisova M, Dobsak P, Dusek L, Jarkovsky J, Novakova M, Shirai K, et al. Cardio-ankle vascular index in subjects with dyslipidaemia and other cardiovascular risk factors. J Atheroscler Thromb. 2013;20:443–451. doi: 10.5551/jat.15420. PubMed DOI
Sitruk-Ware R. New progestagens for contraceptive use. Hum Reprod Update. 2006;12:169–178. doi: 10.1093/humupd/dmi046. PubMed DOI
Cianci A, De Leo V. Individualization of low-dose oral contraceptives. Pharmacological principles and practical indications for oral contraceptives. (Article in Italian) Minerva Ginecol. 2007;59:415–425. PubMed
Rübig A. Drospirenone: a new cardiovascular-active progestin with antialdosterone and antiandrogenic properties. Climacteric. 2003;6(Suppl 3):49–54. PubMed
Silva-Bermudez LS, Toloza FJK, Perez-Matos MC, de Souza RJ, Banfield L, Vargas-Villanueva A, Mendivil CO. Effects of oral contraceptives on metabolic parameters in adult premenopausal women: a meta-analysis. Endocr Connect. 2020;9:978–998. doi: 10.1530/EC-20-0423. PubMed DOI PMC
Yildizhan R, Yildizhan B, Adali E, Yoruk P, Birol F, Suer N. Effects of two combined oral contraceptives containing ethinyl estradiol 30 microg combined with either gestodene or drospirenone on hemostatic parameters, lipid profiles and blood pressure. Arch Gynecol Obstet. 2009;280:255–261. doi: 10.1007/s00404-008-0907-x. PubMed DOI
Sitruk-Ware R. Progestogens in hormonal replacement therapy: new molecules, risks, and benefits. Menopause. 2002;9:6–15. doi: 10.1097/00042192-200201000-00003. PubMed DOI
Enea C, Laffetas P, Pichon A, Delpech N. Arterial stiffness and hemodynamics in young women: the effects of oral contraceptive intake and physical habits. Int J Environ Res Public Health. 2021;18:3393. doi: 10.3390/ijerph18073393. PubMed DOI PMC
Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16:223–237. doi: 10.1038/s41581-019-0244-2. PubMed DOI PMC
Beilin LJ, Puddey IB, Burke V. Lifestyle and hypertension. Am J Hypertens. 1999;12:934–945. doi: 10.1016/S0895-7061(99)00057-6. PubMed DOI
Priest SE, Shenouda N, MacDonald MJ. Effect of sex, menstrual cycle phase, and monophasic oral contraceptive pill use on local and central arterial stiffness in young adults. Am J Physiol Heart Circ Physiol. 2018;315:H357–H365. doi: 10.1152/ajpheart.00039.2018. PubMed DOI PMC
Yu A, Giannone T, Scheffler P, Doonan RJ, Egiziano G, Gomez Y-H, Papaioannou TG, Daskalopoulou SS. The effect of oral contraceptive pills and the natural menstrual cYCLe on arterial stiffness and hemodynamICs (CYCLIC) J Hypertens. 2014;32:100–107. doi: 10.1097/HJH.0000000000000012. PubMed DOI
Minson CT, Halliwill JR, Young TM, Joyner MJ. Sympathetic activity and baroreflex sensitivity in young women taking oral contraceptives. Circulation. 2000;102:1473–1476. doi: 10.1161/01.CIR.102.13.1473. PubMed DOI
Kang AK, Duncan JA, Cattran DC, Floras JS, Lai V, Scholey JW, Miller JA. Effect of oral contraceptives on the renin angiotensin system and renal function. Am J Physiol Regul Integr Comp Physiol. 2001;280:R807–R813. doi: 10.1152/ajpregu.2001.280.3.R807. PubMed DOI
Milyagin VA, Filichkin DE, Shpynev KV, Shpyneva ZM, Milyagina IV. Contour analysis of central and peripheral pulse wave in healthy people and in hypertensive patients. Arter Gipertenz. 2009;15:78–85. doi: 10.18705/1607-419X-2009-15-1-78-85. DOI
Shirai K. Analysis of vascular function using the cardio-ankle vascular index (CAVI) Hypertens Res. 2011;34:684–685. doi: 10.1038/hr.2011.40. PubMed DOI
Shirai K, Saiki A, Nagayama D, Tatsuno I, Shimizu K, Takahashi M. The role of monitoring arterial stiffness with cardio-ankle vascular index in the control of lifestyle-related diseases. Pulse. 2015;3:118–133. doi: 10.1159/000431235. PubMed DOI PMC
Dragoman MV, Tepper NK, Fu R, Curtis KM, Chou R, Gaffield ME. A systematic review and meta-analysis of venous thrombosis risk among users of combined oral contraception. Int J Gynaecol Obstet. 2018;141:287–294. doi: 10.1002/ijgo.12455. PubMed DOI PMC
Abou-Ismail MY, Citla Sridhar D, Nayak L. Estrogen and thrombosis: A bench to bedside review. Thromb Res. 2020;192:40–51. doi: 10.1016/j.thromres.2020.05.008. PubMed DOI PMC
Casey S, Lanting S, Oldmeadow C, Chuter V. The reliability of the ankle brachial index: a systematic review. J Foot Ankle Res. 2019;12:39. doi: 10.1186/s13047-019-0350-1. PubMed DOI PMC
Šudaková M, Budinskaya K, Nováková Z. Evaluation of diastolic heart function using echocardiography and pulse wave analysis in patients after anthracycline therapy. 2021 Comput Cardiol. 2021:1–4. doi: 10.23919/CinC53138.2021.9662816. DOI