Contraception
Volume 73, Issue 2 , Pages 179-188, February 2006

Combined oral contraceptive use among women with hypertension: a systematic review

  • Kathryn M. Curtis

      Affiliations

    • WHO Collaborating Center in Reproductive Health, Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 770 488 6397; fax: +1 770 488 6391.
    • ,
  • Anshu P. Mohllajee

      Affiliations

    • WHO Collaborating Center in Reproductive Health, Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
    • ,
  • Summer L. Martins

      Affiliations

    • WHO Collaborating Center in Reproductive Health, Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
    • ,
  • Herbert B. Peterson

      Affiliations

    • Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
    • Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA

Received 27 July 2005; accepted 11 August 2005. published online 17 October 2005.

Abstract 

Women with hypertension are at increased risk for cardiovascular events. Combined oral contraceptive (COC) use, even among low-dose users, has been associated with a small excess risk for cardiovascular events among healthy women. In this systematic review, we examined cardiovascular risks among COC users with hypertension. After searching MEDLINE for all articles published from 1966 through February 2005 relevant to COC use, hypertension and cardiovascular disease, we identified 25 articles for this review. Overall, these studies showed that hypertensive COC users were at higher risk for stroke and acute myocardial infarction (AMI) than hypertensive non-COC users, but that they were not at higher risk for venous thromboembolism (VTE). Women who did not have their blood pressure measured before initiating COC use were at higher risk for ischemic stroke and AMI, but not for hemorrhagic stroke or VTE, than COC users who did not have their blood pressure measured.

Keywords: Combined oral contraceptives, Hypertension, Stroke, Myocardial infarction, Venous thromboembolism, Systematic review

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PII: S0010-7824(05)00313-6

doi:10.1016/j.contraception.2005.08.005

Contraception
Volume 73, Issue 2 , Pages 179-188, February 2006

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