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Epidemiology of oral contraceptives and cardiovascular disease.
Ann Intern Med. 1998 Mar 15; 128(6):467-77.AIM

Abstract

PURPOSE

To review the association between combined oral contraceptives and cardiovascular disease, with emphasis on oral contraceptives containing low doses of estrogen (low-dose oral contraceptives).

DATA SOURCES

A systematic search of the MEDLINE database was done for all relevant articles published between 1967 (when low-dose oral contraceptives were introduced in the United States) and June 1997. Textbooks, meeting proceedings, and reference lists were also searched.

STUDY SELECTION

All English-language human epidemiology studies of oral contraceptives that used cardiovascular disease as an end point were reviewed. Animal and metabolic studies were reviewed only if they were especially relevant to the mechanism of action of oral contraceptives.

DATA EXTRACTION

Descriptive and analytic data from each study were collected.

DATA SYNTHESIS

Data were organized by cardiovascular end point, study design, estrogen dose, and type of progestogen. Data on relative and absolute risk are presented to address current prescription guidelines.

CONCLUSIONS

The risk for cardiovascular disease is lower with current preparations of oral contraceptives, including those that contain the new progestogens, than with older oral contraceptives containing high doses of estrogen. Among users of low-dose oral contraceptives, cardiovascular diseases occur mainly in smokers and women with predisposing factors. Every effort should be made to encourage smoking cessation among potential users of oral contraceptives.

Authors+Show Affiliations

Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

9499331

Citation

Chasan-Taber, L, and M J. Stampfer. "Epidemiology of Oral Contraceptives and Cardiovascular Disease." Annals of Internal Medicine, vol. 128, no. 6, 1998, pp. 467-77.
Chasan-Taber L, Stampfer MJ. Epidemiology of oral contraceptives and cardiovascular disease. Ann Intern Med. 1998;128(6):467-77.
Chasan-Taber, L., & Stampfer, M. J. (1998). Epidemiology of oral contraceptives and cardiovascular disease. Annals of Internal Medicine, 128(6), 467-77.
Chasan-Taber L, Stampfer MJ. Epidemiology of Oral Contraceptives and Cardiovascular Disease. Ann Intern Med. 1998 Mar 15;128(6):467-77. PubMed PMID: 9499331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiology of oral contraceptives and cardiovascular disease. AU - Chasan-Taber,L, AU - Stampfer,M J, PY - 1998/3/14/pubmed PY - 1998/3/14/medline PY - 1998/3/14/entrez KW - Americas KW - Behavior KW - Biology KW - Cardiovascular Effects KW - Contraception KW - Contraceptive Methods--side effects KW - Developed Countries KW - Europe KW - Family Planning KW - Literature Review KW - North America KW - Northern America KW - Northern Europe KW - Oral Contraceptives, Combined--side effects KW - Oral Contraceptives--side effects KW - Physiology KW - Risk Factors KW - Smoking KW - United Kingdom KW - United States SP - 467 EP - 77 JF - Annals of internal medicine JO - Ann Intern Med VL - 128 IS - 6 N2 - PURPOSE: To review the association between combined oral contraceptives and cardiovascular disease, with emphasis on oral contraceptives containing low doses of estrogen (low-dose oral contraceptives). DATA SOURCES: A systematic search of the MEDLINE database was done for all relevant articles published between 1967 (when low-dose oral contraceptives were introduced in the United States) and June 1997. Textbooks, meeting proceedings, and reference lists were also searched. STUDY SELECTION: All English-language human epidemiology studies of oral contraceptives that used cardiovascular disease as an end point were reviewed. Animal and metabolic studies were reviewed only if they were especially relevant to the mechanism of action of oral contraceptives. DATA EXTRACTION: Descriptive and analytic data from each study were collected. DATA SYNTHESIS: Data were organized by cardiovascular end point, study design, estrogen dose, and type of progestogen. Data on relative and absolute risk are presented to address current prescription guidelines. CONCLUSIONS: The risk for cardiovascular disease is lower with current preparations of oral contraceptives, including those that contain the new progestogens, than with older oral contraceptives containing high doses of estrogen. Among users of low-dose oral contraceptives, cardiovascular diseases occur mainly in smokers and women with predisposing factors. Every effort should be made to encourage smoking cessation among potential users of oral contraceptives. SN - 0003-4819 UR - https://www.unboundmedicine.com/medline/citation/9499331/Epidemiology_of_oral_contraceptives_and_cardiovascular_disease_ L2 - https://www.acpjournals.org/doi/10.7326/0003-4819-128-6-199803150-00008?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -