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Case-control study of oral contraceptives and risk of thromboembolic stroke: results from International Study on Oral Contraceptives and Health of Young Women.
BMJ. 1997 Dec 06; 315(7121):1502-4.BMJ

Abstract

OBJECTIVE

To determine the influence of oral contraceptives (particularly those containing modern progestins) on the risk for ischaemic stroke in women aged 16-44 years.

DESIGN

Matched case-control study.

SETTING

16 Centres in the United Kingdom, Germany, France, Switzerland, and Austria.

SUBJECTS

Cases were 220 women aged 16-44 who had an incident ischaemic stroke. Controls were 775 women (at least one hospital and one community control per case) unaffected by stroke who were matched with the corresponding case for 5 year age band and for hospital or community setting. Information on exposure and confounding variables were collected in a face to face interview.

MAIN OUTCOME MEASURES

Odds ratios derived with stratified analysis and unconditional logistic regression to adjust for potential confounding.

RESULTS

Adjusted odds ratios (95% confidence intervals) for ischaemic stroke (unmatched analysis) were 4.4 (2.0 to 9.9), 3.4 (2.1 to 5.5), and 3.9 (2.3 to 6.6) for current use of first, second, and third generation oral contraceptives, respectively. The risk ratio for third versus second generation was 1.1 (0.7 to 2.0) and was similar in the United Kingdom and other European countries. The risk estimates were lower if blood pressure was checked before prescription.

CONCLUSION

Although there is a small relative risk of occlusive stroke for women of reproductive age who currently use oral contraceptives, the attributable risk is very small because the incidence in this age range is very low. There is no difference between the risk of oral contraceptives of the third and second generation; only first generation oral contraceptives seem to be associated with a higher risk. This small increase in risk may be further reduced by efforts to control cardiovascular risk factors, particularly high blood pressure.

Authors+Show Affiliations

ZEG-Centre for Epidemiology and Health Research Berlin, Zepernick, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

9420491

Citation

Heinemann, L A., et al. "Case-control Study of Oral Contraceptives and Risk of Thromboembolic Stroke: Results From International Study On Oral Contraceptives and Health of Young Women." BMJ (Clinical Research Ed.), vol. 315, no. 7121, 1997, pp. 1502-4.
Heinemann LA, Lewis MA, Thorogood M, et al. Case-control study of oral contraceptives and risk of thromboembolic stroke: results from International Study on Oral Contraceptives and Health of Young Women. BMJ. 1997;315(7121):1502-4.
Heinemann, L. A., Lewis, M. A., Thorogood, M., Spitzer, W. O., Guggenmoos-Holzmann, I., & Bruppacher, R. (1997). Case-control study of oral contraceptives and risk of thromboembolic stroke: results from International Study on Oral Contraceptives and Health of Young Women. BMJ (Clinical Research Ed.), 315(7121), 1502-4.
Heinemann LA, et al. Case-control Study of Oral Contraceptives and Risk of Thromboembolic Stroke: Results From International Study On Oral Contraceptives and Health of Young Women. BMJ. 1997 Dec 6;315(7121):1502-4. PubMed PMID: 9420491.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Case-control study of oral contraceptives and risk of thromboembolic stroke: results from International Study on Oral Contraceptives and Health of Young Women. AU - Heinemann,L A, AU - Lewis,M A, AU - Thorogood,M, AU - Spitzer,W O, AU - Guggenmoos-Holzmann,I, AU - Bruppacher,R, PY - 1998/1/8/pubmed PY - 1998/1/8/medline PY - 1998/1/8/entrez KW - Austria KW - Biology KW - Case Control Studies KW - Cerebrovascular Effects KW - Contraception KW - Contraceptive Methods--side effects KW - Developed Countries KW - Diseases KW - Embolism KW - Europe KW - Family Planning KW - France KW - Germany KW - Mediterranean Countries KW - Northern Europe KW - Oral Contraceptives, Combined--side effects KW - Oral Contraceptives--side effects KW - Physiology KW - Research Methodology KW - Research Report KW - Risk Factors KW - Studies KW - Switzerland KW - Thromboembolism KW - United Kingdom KW - Vascular Diseases KW - Western Europe SP - 1502 EP - 4 JF - BMJ (Clinical research ed.) JO - BMJ VL - 315 IS - 7121 N2 - OBJECTIVE: To determine the influence of oral contraceptives (particularly those containing modern progestins) on the risk for ischaemic stroke in women aged 16-44 years. DESIGN: Matched case-control study. SETTING: 16 Centres in the United Kingdom, Germany, France, Switzerland, and Austria. SUBJECTS: Cases were 220 women aged 16-44 who had an incident ischaemic stroke. Controls were 775 women (at least one hospital and one community control per case) unaffected by stroke who were matched with the corresponding case for 5 year age band and for hospital or community setting. Information on exposure and confounding variables were collected in a face to face interview. MAIN OUTCOME MEASURES: Odds ratios derived with stratified analysis and unconditional logistic regression to adjust for potential confounding. RESULTS: Adjusted odds ratios (95% confidence intervals) for ischaemic stroke (unmatched analysis) were 4.4 (2.0 to 9.9), 3.4 (2.1 to 5.5), and 3.9 (2.3 to 6.6) for current use of first, second, and third generation oral contraceptives, respectively. The risk ratio for third versus second generation was 1.1 (0.7 to 2.0) and was similar in the United Kingdom and other European countries. The risk estimates were lower if blood pressure was checked before prescription. CONCLUSION: Although there is a small relative risk of occlusive stroke for women of reproductive age who currently use oral contraceptives, the attributable risk is very small because the incidence in this age range is very low. There is no difference between the risk of oral contraceptives of the third and second generation; only first generation oral contraceptives seem to be associated with a higher risk. This small increase in risk may be further reduced by efforts to control cardiovascular risk factors, particularly high blood pressure. SN - 0959-8138 UR - https://www.unboundmedicine.com/medline/citation/9420491/Case_control_study_of_oral_contraceptives_and_risk_of_thromboembolic_stroke:_results_from_International_Study_on_Oral_Contraceptives_and_Health_of_Young_Women_ L2 - https://www.bmj.com/lookup/pmidlookup?view=long&pmid=9420491 DB - PRIME DP - Unbound Medicine ER -