Oral contraceptives, risk factor of myocardial infarction related to blood lipids
Limouzin-lamothe, M.A.; Serog, P.
Contraception Fertilite Sexualite 8(4): 295-303
1980
ISSN/ISBN: 0301-861X PMID: 12278330 Document Number: 167227
Retrospective studies show that OC (oral contraception) increases female mortality due to cardiovascular deficiency. According to a 1977 study of the Royal College of General Practitioners, the mortality rate for pill users between 15-24 is 14.9/100,000, against 11.8/100,000 for nonusers, and 241.50/100,000 against 119.50/100,000 in the age group 45-49. While between 1950-60 the incidence of infarction diminished for women in all age groups, between 1960-70 mortality for infarction increased 50%, and strictly in those countries where the pill had a great diffusion. It is believed that about 40% of infarctions before 45 are among OC users. Cardiovascular risk is increased by perturbations of the lipid metabolic system, and the combined effects of estroprogestational agents on circulating cholesterol level differs according to the composition used. Ethinyl estradiol increases the level of circulating cholesterol, while derivates from norethindrone diminish it. It can be concluded that estroprogestational associations tend to increase the level of circulating triglycerides, except when this effect is moderated by the presence of Norgestrel. Any prescription for OC must be preceded by a severe lipid evaluation; for women over 40 the use of an IUD would be better indicated than OC.