, Volume 23, Issue 3, pp 149-157

Oral contraceptive use is associated with increased cardiovascular reactivity in nonsmokers

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Women who smoke and take oral contraceptives (OCs) have significantly increased risk of cardiovascular disease, but the exact mechanisms for the increased risk are not known. Cardiovascular reactivity to psychological stress may be one mechanism for the enhanced risk, but the small number of studies examining whether OC users who smoke have greater reactivity have produced mixed results. The purpose of this study was to examine the effect of chronic cigarette smoking, acute nicotine administration, and OC use on cardiovascular and lipid reactivity. Sixty healthy women, half of whom had been using OCs for at least the previous 6 months, participated in the study. Approximately two thirds were smokers and were randomized to be tested after either a 12-hr nicotine deprivation or administration of nicotine gum. One third were nonsmokers. Heart rate, blood pressure, and lipid measures were taken at rest, during a videotaped speech task, and during recovery from the task. Results indicated that, among OC nonusers, there was no effect of smoking status or nicotine administration on cardiovascular reactivity. However, among OC users, nonsmokers had significantly greater heart rate and diastolic blood pressure reactivity to stress. These data show that acute nicotine administration, in the form of nicotine gum, has no effect on cardiovascular or lipid stress reactivity in women. However, OC use among nonsmoking women is associated with greater cardiovascular reactivity to stress.

This work was supported in part by National Institutes of Health HL48363 and HL44847 to Catherine M. Stoney and by an Ohio State University Postdoctoral Fellowship Award to Shelia G. West.
We thank the participants. We also gratefully acknowledge the expert assistance of Dr. Linda Bausserman for the analysis of the lipid assays.