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Modern oral contraceptives and cardiovascular disease.
Am J Obstet Gynecol. 1997 Sep; 177(3):707-15.AJ

Abstract

We reviewed evidence that bears on the cardiovascular safety of combined oral contraceptives containing second- and third-generation progestogens and < 50 micrograms of estrogen. Recent epidemiologic studies indicate that current use of these formulations is associated with a smaller increase in the incidence of venous thromboembolism than earlier formulations. In some studies the increase for third-generation formulations containing desogestrel or gestodene was about 1.5 to 2 times that for second-generation formulations, but there is evidence that differences between users in underlying risk and likelihood of being diagnosed contributed to this result. Recent studies of myocardial infarction suggest a smaller increase in risk associated with modern formulations than with earlier ones; one study suggests a threefold increase for second-generation formulations and no increase for third-generation formulations, but the finding requires confirmation. Recent studies of stroke indicate little or no increase in risk for modern formulations among women without risk factors. We conclude that modern combined oral contraceptives are safer than earlier formulations with respect to cardiovascular disease, which occurs rarely in young women.

Authors+Show Affiliations

Slone Epidemiology Unit, Boston University School of Medicine, MA, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

9322646

Citation

Rosenberg, L, et al. "Modern Oral Contraceptives and Cardiovascular Disease." American Journal of Obstetrics and Gynecology, vol. 177, no. 3, 1997, pp. 707-15.
Rosenberg L, Palmer JR, Sands MI, et al. Modern oral contraceptives and cardiovascular disease. Am J Obstet Gynecol. 1997;177(3):707-15.
Rosenberg, L., Palmer, J. R., Sands, M. I., Grimes, D., Bergman, U., Daling, J., & Mills, A. (1997). Modern oral contraceptives and cardiovascular disease. American Journal of Obstetrics and Gynecology, 177(3), 707-15.
Rosenberg L, et al. Modern Oral Contraceptives and Cardiovascular Disease. Am J Obstet Gynecol. 1997;177(3):707-15. PubMed PMID: 9322646.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modern oral contraceptives and cardiovascular disease. AU - Rosenberg,L, AU - Palmer,J R, AU - Sands,M I, AU - Grimes,D, AU - Bergman,U, AU - Daling,J, AU - Mills,A, PY - 1997/10/10/pubmed PY - 1997/10/10/medline PY - 1997/10/10/entrez KW - Biology KW - Cerebrovascular Effects KW - Contraception KW - Contraceptive Agents, Female--pharmacodynamics KW - Contraceptive Agents, Progestin--pharmacodynamics KW - Contraceptive Agents--pharmacodynamics KW - Contraceptive Methods--side effects KW - Desogestrel--pharmacodynamics KW - Diseases KW - Embolism KW - Evaluation KW - Family Planning KW - Gestodene--pharmacodynamics KW - Heart Diseases KW - Levonorgestrel--pharmacodynamics KW - Literature Review KW - Myocardial Infarction KW - Oral Contraceptives, Combined--side effects KW - Oral Contraceptives--side effects KW - Physiology KW - Risk Assessment KW - Risk Factors KW - Thromboembolism KW - Vascular Diseases SP - 707 EP - 15 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 177 IS - 3 N2 - We reviewed evidence that bears on the cardiovascular safety of combined oral contraceptives containing second- and third-generation progestogens and < 50 micrograms of estrogen. Recent epidemiologic studies indicate that current use of these formulations is associated with a smaller increase in the incidence of venous thromboembolism than earlier formulations. In some studies the increase for third-generation formulations containing desogestrel or gestodene was about 1.5 to 2 times that for second-generation formulations, but there is evidence that differences between users in underlying risk and likelihood of being diagnosed contributed to this result. Recent studies of myocardial infarction suggest a smaller increase in risk associated with modern formulations than with earlier ones; one study suggests a threefold increase for second-generation formulations and no increase for third-generation formulations, but the finding requires confirmation. Recent studies of stroke indicate little or no increase in risk for modern formulations among women without risk factors. We conclude that modern combined oral contraceptives are safer than earlier formulations with respect to cardiovascular disease, which occurs rarely in young women. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/9322646/Modern_oral_contraceptives_and_cardiovascular_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(97)70168-6 DB - PRIME DP - Unbound Medicine ER -