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Low-dose oral contraceptives increase cardiovascular disease risk
  NEW YORK (Reuters Health, July 12, 2005) - Low-dose oral contraceptives increase the risk of both cardiac and vascular arterial events, according to a report in the July Journal of Clinical Endocrinology and Metabolism.
Although previous studies have suggested a relationship between oral contraceptive use and cardiovascular disease, the authors explain, studies in women using low-dose second- and third-generation oral contraceptives have yielded inconsistent results.
Dr. Jean-Patrice Baillargeon from University of Sherbrooke in Quebec, Canada, and colleagues conducted a meta-analysis of 14 studies to estimate the risk of cardiac or vascular arterial events associated with the current use of low-dose combined oral contraceptives in women.
Overall, the use of low-dose oral contraceptives was associated with a doubling of the risk of cardiovascular outcomes (myocardial infarction or ischemic stroke), the authors report. With low-dose oral contraceptive use, the relative risk of myocardial infarction was 1.84 and the RR of ischemic stroke was 2.12, the report indicates.
Both second- and third-generation oral contraceptives were associated with a significantly increased risk of ischemic stroke, the researchers note, but the association between third-generation oral contraceptive use and myocardial infarction proved nonsignificant.
"The modern use of low-dose oral contraceptives, limited to healthy women and restricted in time, should not increase noticeably the incidence of these adverse outcomes, which might be outweighed by the benefits of contraception," the investigators conclude.
"However, prolonged exposure to low-dose oral contraceptives in a population at higher risk may significantly increase the incidence of cardiovascular outcomes and prompt consideration of alternative therapeutic or contraceptive interventions."
J Clin Endocrinol Metab 2005;90:3863-3870.
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