Research finds various cardiovascular risks associated with different hormonal contraceptives

Certain hormonal contraceptives are associated with higher stroke and heart attack risk, finding large studies from Denmark BMJ Today, prescription records are used to provide more accurate estimates of products that differ from previous studies.

The highest risk estimates were products containing estrogen, particularly those containing vaginal rings and skin patches.

Researchers emphasize that absolute risk remains low, but given the widespread use of these products and the severity of these conditions, clinicians are likely to have these potential when prescribing them. They say they should consider the risks.

It is estimated that around 250 million women worldwide will use hormonal contraception. Previous studies suggest that potential risks of ischemic stroke and heart attacks use them, but the findings were inconsistent.

There is also a lack of evidence regarding the effects of various hormone combinations, how they are adopted (tablets, implants, injections, vaginal rings or skin patches), and how long it lasts.

To bridge this knowledge gap, researchers tracked national prescription records of more than 2 million Danish women aged 15-49 between 1996 and 2021, and used modern hormonal contraceptives for the first time. We investigated whether this increased the risk of ischemic stroke and heart attack. .

The various types of contraception they included were combinations of estrogen-progestin pills, vaginal circles, patches, progestin-only pills, intrauterine devices, subcutaneous implants, and intramuscular injections.

Women will be excluded if they have a history of thrombosis, cancer, liver disease, kidney disease, polycystic ovarian syndrome, endometriosis or infertility treatment, and Had a hysterectomy.

Cases of ischemic stroke and heart attack were recorded, and potentially influential factors such as age, education level, and pre-existing conditions such as hypertension and diabetes were considered.

The most commonly used hormonal contraceptives – estrogen – combined with progestin pills – was associated with twice the risk of ischemic stroke and heart attacks. For every 10,000 women a year.

Progestin-only contraceptives, including pills and implants, took a slightly elevated risk, although lower than total pills. The risk of non-oral contraceptives such as vaginal rings and patches is high, with vaginal rings increasing the risk of ischemic stroke 2.4 times, heart attack risk 3.8 times, and patches increase the risk of ischemic stroke 3.4 times. Ta.

The intrauterine system dedicated to progestins is the only hormonal contraceptive that is not associated with increased risk, and this option has become safer for cardiovascular health. The duration of use did not affect the risk.

As this is an observational study, we cannot draw solid conclusions about causes and effects. Researchers cannot rule out the possibility that other unmeasured factors influenced the outcome.

However, this is a national study using high-quality registry data that allows for detailed follow-up of hormonal contraceptive use, and the results are consistent after further analysis, suggesting that they are robust. I'm doing it.

Thus, they conclude: “While the absolute risk was low, clinicians should include the potential risk of arterial thrombosis in their assessment of benefits and risks when prescribing hormonal contraception.”

These illnesses are rare, particularly among younger women, and Swedish Institute of Technology, Therese Johansson, is the linked editor. Nevertheless, these side effects are serious and the results are important given that approximately 248 million women use hormonal contraceptives every day.

She seeks educational campaigns to help women make informed choices, ensuring training and consistent evidence-based counseling for healthcare providers.

Policymakers also provide for women with affordable and accessible cardiovascular risk factors, especially in low-resource settings where cardiovascular risk is frequently diagnosed and untreated. She adds that making safer alternatives should be a priority.