Abstract
Background
Hypertension is a primary cardiovascular risk factor. Oral contraceptives (OCs) may
increase blood pressure and cardiovascular events. We evaluated whether an OC containing
ethynylestradiol (EE) in association with the spironolactone-derived progestin drospirenone
(DRSP) influences 24-h ambulatory blood pressure of normotensive women.
Study Design
Twenty-four-hour blood pressure was measured every 30 min by an ambulatory blood pressure
device in 18 normotensive healthy women prior to and after 6 months of use of an OC
containing 30 mcg EE and 3 mg DRSP.
Results
OC induced no modification in 24-h, nighttime and daytime blood pressure. Heart rate
increased about 4 beats/min in the 24-h (p<.05) and daytime (p<.02) measurements.
Conclusions
In normotensive women, an OC containing 30 mcg EE plus 3 mg DRSP does not modify blood
pressure, and significantly increases 24-h and daytime heart rate. These data suggest
a neutral effect on hypertension-associated cardiovascular risk and point out an unreported
effect on heart rate of which cause and effect require further evaluation.
Keywords
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References
- Heart disease and stroke statistics — 2011 update: a report from the American Heart Association.Circulation. 2011; 123: 18-209
- Ischaemic stroke and combined oral contraceptives: results of an international multicentre case control study.Lancet. 1996; 348: 498-505
- Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: results of an international, multicentre, case–control study.Lancet. 1996; 348: 505-510
- Acute myocardial infarction and combined oral contraceptives: results of an international multicentre case–control study.Lancet. 1997; 349: 1202-1209
- Haemostatic, lipid and blood-pressure profiles of women on oral contraceptives containing 50 μg or 30 μg oestrogen.Lancet. 1977; 2: 948-951
- Br. A prospective controlled study of the effect on blood pressure of contraceptive preparations containing different types and dosages of progestogen.J Obstet Gynaecol. 1984; 91: 1254-1260
World Health Organization. Medical eligibility criteria for contraceptive use (4thed.) World organization (2009) fromhttp://whqlibdoc.who.int/publications/2009/9789241563888_eng.pdf.
- Ambulatory blood pressure in mild hypertensive women taking oral contraceptives. A case–control study.Am J Hypertens. 1995; 8: 249-253
- Blood pressure in women taking oral contraceptives.Br Med J. 1974; 1: 533-535
- Oral contraceptives and blood pressure.JAMA. 1977; 237: 2499-2503
- Effect on blood pressure of changing from high to low dose steroid preparations in women with oral contraceptive induced hypertension.Scott Med J. 1982; 27: 212-215
- The effect on blood pressure of a monophasic oral contraceptive containing ethinylestradiol and gestodene.Contraception. 1995; 51: 335-339
- Blood pressure in women taking oral contraceptives.Am Heart J. 1976; 92: 119-120
- Relationships between blood pressure, oral contraceptive use and metabolic risk markers for cardiovascular disease.Contraception. 1995; 52: 143-149
- Oestrogen content of oral contraceptives.Lancet. 1977; 2: 1233
- Women and coronary artery disease.Postgrad Med. 1990; 87: 55-60
- Evaluation of plasma levels of renin-aldosterone and blood pressure in women over 35 years treated with new oral contraceptives.Contraception. 2001; 64: 145-148
- Low-dose oral contraceptives and 24-hour ambulatory blood pressure.Int J Gynaecol Obstet. 1997; 59: 237-244
- Effects of metformin versus ethinyl-estradiol plus cyproterone acetate on ambulatory blood pressure monitoring and carotid intima media thickness in women with the polycystic ovary syndrome.Fertil Steril. 2009; 91: 2527-2536
- A study of the interactive effects of oral contraceptive use and dietary fat intake on blood pressure, cardiovascular reactivity and glucose tolerance in normotensive women.J Hypertens. 1998; 16: 357-368
- Alteration by oral contraceptives of normal menstrual changes in plasma renin activity, concentration and substrate.Clin Sci. 1969; 36: 67-76
- Conception and pharmacological profile of drospirenone.Steroids. 2003; 68: 891-905
- Endocrine pharmacological profile of gestodene E.in: Elstein Gestodene. Development of a new gestodene-containing low dose oral contraceptive. Parthenon Publishing, Carnforth (UK)1987: 19-33
- Antimineralocorticoid activity of a novel oral contraceptive containing drospirenone, a unique progestogen resembling natural progesterone.Eur J Contracept Reprod Health Care. 2002; 7: 19-26
- Resting heart rate in cardiovascular disease.J Am Coll Cardiol. 2007; 50: 823-830
- Vascular pathophysiology in resonse to increased heart rate.J Am Coll Cardiol. 2010; 56: 1973-1983
- Assessment of association of increased heart rates to cardiovascular events among healthy subjects in the United States: analysis of primary care electronic medical records database.ISRN Cardiology. 2011; 2011: 924343https://doi.org/10.5402/2011/924343
- Eur Heart J. 2007; 28: 1462-1536
- Prolonged melatonin administration decreases nocturnal blood pressure in women.Am J Hypertens. 2005; 18: 1614-1618
- Revisiting the relation between change and initial value: a review and evaluation.Statist Med. 2007; 26: 443-457
- Effects of a new hormone therapy, drospirenone and 17-beta-estradiol, in postmenopausal women with hypertension.Hypertension. 2006; 48: 246-253
- Effects of two combined oral contraceptives containing ethinylestradiol 30 mcg combined with either gestodene or drospirenone on hemostatic parameters, lipid profiles and blood pressure.Arch Gynecol Obstet. 2009; 280: 255-261
- An open-label randomized comparative study of oral contraceptives between medications containing 3 mg drospirenone/30 microg ethinylestradiol and 150 microg levonogestrel/30 microg ethinylestradiol in Thai women.Contraception. 2004; 69: 23-26
- Polycystic ovary syndrome and cardiovascular risk in young patients treated with drospirenone-ethinylestradiol or contraceptive vaginal ring. A prospective, randomized, pilot study.Fertil Steril. 2010; 94: 1417-1425
- Administration of tibolone decreases 24 h heart rate but not blood pressure of post-menopausal women.Maturitas. 2004; 48: 155-160
- Oral contraceptives alter circadian rhythm parameters of cortisol, melatonin, blood pressure, heart rate, skin blood flow, transepidermal water loss, and skin amino acids of healthy young women.Chronobiol Int. 1996; 13: 199-211
- Spironolactone preserves cardiac norepinephrine reuptake in salt-sensitive Dahl rats.Endocrinology. 2006; 147: 2526-2534
- Normal sympathetic vasomotor and cardiac parasympathetic activities in patients with primary aldosteronism: assessment by spectral analysis.J Auton Nerv Syst. 1995; 52: 213-223
- Effect of an oral contraceptive containing 30 microg ethinylestradiol plus 3 mg drospirenone on body composition of young women affected by premenstrual syndrome with symptoms of water retention.Contraception. 2007; 76: 190-194
- Heart rate as a cardiovascular risk factor: do women differ from men?.Ann Med. 2001; 33: 213-221
Article info
Publication history
Published online: December 12, 2012
Accepted:
December 1,
2012
Received in revised form:
November 29,
2012
Received:
October 2,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
