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Cardiovascular disease incidence among females in South Carolina by type of oral contraceptives, 2000–2013: a retrospective cohort study

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Introduction

Certain types of oral contraceptives can produce favorable effects on lipid metabolism and vascular tone, while others have potentially detrimental effects. Endogenous and exogenous hormones exert different effects on high-density lipoprotein (HDL) and low-density lipoprotein (LDL) depending on the type, combination, and dose of the hormone. The estrogenic and progestogenic effects of exogenous hormones on HDL and LDL are inconsistent. Studying surrogate end points (LDL, HDL levels) may provide a misleading picture of OCs.

Methods

Medicaid data from 2000 to 2013 were used to assess the relationship between the type of OCs and CVD incidence. Multivariable logistic regression was used to model relationships between cardiovascular disease and OC use adjusting for potential confounders.

Results

Compared to combined oral contraceptives (COC), progestin-only oral contraceptives (POC) were associated with decreased heart disease and stroke incidence after adjusting for important covariates (OR 0.74; 95 % CI 0.57, 0.97 and OR 0.39; 95 % CI 0.16, 0.95, respectively). However, there was a positive association between POC + COC and both heart disease and stroke incidence (OR 2.28; 95 % CI 1.92, 2.70 and OR 2.12; 95 % CI 1.34, 3.35, respectively).

Conclusion

In light of an association between POC use and decreased heart disease and stroke, women’s CVD risk factors should be carefully considered when choosing which OC to use. Baseline CVD risk should be a part of the discussion between women and their primary care providers when making choices regarding OCs.

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Author information

Authors and Affiliations

  1. Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Columbia, SC, USA

    Marsha E. Samson, Swann A. Adams, Jiajia Zhang & James R. Hebert

  2. College of Nursing, University of South Carolina, Columbia, SC, USA

    Swann A. Adams & Jiajia Zhang

  3. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    Marsha E. Samson, Swann A. Adams, Anwar T. Merchant & James R. Hebert

  4. South Carolina College of Pharmacy, University of South Carolina, Columbia, SC, USA

    Whitney D. Maxwell & Charles L. Bennett

Authors
  1. Marsha E. Samson
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  2. Swann A. Adams
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  3. Anwar T. Merchant
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Corresponding author

Correspondence to Marsha E. Samson.

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None to disclose, and we had control of only secondary data through Medicaid.

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Samson, M.E., Adams, S.A., Merchant, A.T. et al. Cardiovascular disease incidence among females in South Carolina by type of oral contraceptives, 2000–2013: a retrospective cohort study. Arch Gynecol Obstet 294, 991–997 (2016). https://doi.org/10.1007/s00404-016-4143-5

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  • DOI: https://doi.org/10.1007/s00404-016-4143-5

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