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ORAL CONTRACEPTIVES: NOT A MAJOR CAUSE OF HYPERTENSION.

Oral contraceptives with high doses of estrogen and progesterone induce hypertension in about 5 percent of users, but the formulation of birth control pills has changed markedly over the last few decades. To assess the impact of oral contraceptives on the prevalence of hypertension, researchers from the Nurses Health Study examined the incidence of new hypertension among 68,297 nurses who were free of hypertension, diabetes, coronary disease, stroke, and cancer at baseline.

During the next four years, 1567 women developed hypertension. Overall, oral contraceptive users had systolic blood pressures averaging 0.7 mm Hg higher, and diastolic pressures 0.4 mm Hg higher, than women who had never used them. Multivariate analysis indicated that current oral contraceptive use increased the risk for hypertension by 80 percent, with the highest risk among long-term users. However, the risk decreased quickly after cessation of birth control pills.

Comment: Although oral contraceptives raise a woman's risk for hypertension, the overall impact is small, since the rate of hypertension among premenopausal women is low, and the risk quickly diminishes after their cessation. Therefore, concern about hypertension should not be a major limiting factor of this therapy.

— TH Lee

Published in Journal Watch General Medicine August 13, 1996

Citation(s):

Chasan-Taber L et al. Prospective study of oral contraceptives and hypertension among women in the United States. Circulation 1996 Aug 1 94 483-489.

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