Oral Contraceptive Use and the Cardiovascular Health of Canadian Women
| Autor: | Joanne Gunby, John A. Collins |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Gynecology
medicine.medical_specialty medicine.drug_class business.industry Obstetrics Cardiovascular health Mortality rate Disease medicine.disease Contraceptive use Relative risk Meta-analysis medicine cardiovascular diseases Myocardial infarction business Progestin hormones hormone substitutes and hormone antagonists |
| Zdroj: | Journal SOGC. 19:125-137 |
| ISSN: | 0849-5831 |
| DOI: | 10.1016/s0849-5831(16)30889-8 |
| Popis: | Objectives: to review the published literature on the association between oral contraceptive (OC) use and cardiovascular disease, in particular venous thromboembolism (VTE) and acute myocardial infarction (AMI). To determine if there is an increased risk for VTE due to the use of the new progestins. To use the results of the analysis to construct a Canadian model. Methods: meta-regression was used to analyze adjusted relative risks from 18 studies for VTE and from 15 studies for AMI. The resulting risks were applied to the Canadian population of OC users, to calculate event and mortality rates for both, second and third generation progestin use. Results: the relative risk of VTE with the use of OCs consisting of low dose ethinyl estradiol (EE) with new progestins was 7.7 and with other progestins was 3.5, compared with non-use. The relative risk of AMI with new progestins was 1.2 and with other progestins was 2.9. In the Canadian model, there were 25 VTE and two AMI events annually/100,000 women for users of OCs with new progestins, and 11 VTE and four AMI events for users of OCs with other progestins, compared to three VTE and two AMI events for similar non-users. The exclusive use of OCs with new progestins potentially would decrease by seven the annual number of OC-attributable cardiovascular deaths in Canada. Conclusions: the published results appear to exaggerate both the VTE risk and the AMI benefit associated with the new progestins, because of bias including differences in the duration of use. Oral contraceptives should be avoided by women with other risk factors for cardiovascular disease; however, the typical OC user should not avoid or choose an OC based on the extremely small shifts in the cardiovascular risks between VTE and AMI. |
| Databáze: | OpenAIRE |
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