Oral Contraceptive Pills and Hypertension: A Review of Current Evidence and Recommendations
Oral contraceptive pills (OCPs) have been used as effective and popular forms of contraception since the middle of the last century. By 2019, over 150 million reproductive-aged individuals were using OCPs to prevent unintended pregnancies worldwide. Safety concerns regarding the effects of OCPs on b...
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| Published in | Hypertension (Dallas, Tex. 1979) Vol. 80; no. 5; pp. 924 - 935 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Lippincott Williams & Wilkins
01.05.2023
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Oral contraceptive pills (OCPs) have been used as effective and popular forms of contraception since the middle of the last century. By 2019, over 150 million reproductive-aged individuals were using OCPs to prevent unintended pregnancies worldwide. Safety concerns regarding the effects of OCPs on blood pressure were reported soon after these pills gained approval. Although OCP doses were subsequently reduced, epidemiologic evidence continued to support a smaller, but significant association between OCPs and hypertension. Given the rising prevalence of hypertension, as well as the adverse effects of cumulative exposure to blood pressure elevations on cardiovascular disease risk, understanding the nature of the association between OCPs and hypertension is important for clinicians and patients to assess the risks and benefits of use, and make individualized decisions regarding contraception. Therefore, this review summarizes the current and historical evidence describing the association between OCP use and blood pressure elevations. Specifically, it identifies the pathophysiologic mechanisms linking OCPs to hypertension risk, describes the magnitude of the association between OCPs and blood pressure elevations, and distinguishes the effects of various OCP types on blood pressure. Finally, it describes current recommendations regarding hypertension and OCP use, as well as identifies strategies, such as over-the-counter OCP prescribing, to safely and equitably improve access to oral contraception. |
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| AbstractList | Oral contraceptive pills (OCPs) have been used as effective and popular forms of contraception since the middle of the last century. By 2019, over 150 million reproductive-aged individuals were using OCPs to prevent unintended pregnancies worldwide. Safety concerns regarding the effects of OCPs on blood pressure were reported soon after these pills gained approval. Although OCP doses were subsequently reduced, epidemiologic evidence continued to support a smaller, but significant association between OCPs and hypertension. Given the rising prevalence of hypertension, as well as the adverse effects of cumulative exposure to blood pressure elevations on cardiovascular disease risk, understanding the nature of the association between OCPs and hypertension is important for clinicians and patients to assess the risks and benefits of use, and make individualized decisions regarding contraception. Therefore, this review summarizes the current and historical evidence describing the association between OCP use and blood pressure elevations. Specifically, it identifies the pathophysiologic mechanisms linking OCPs to hypertension risk, describes the magnitude of the association between OCPs and blood pressure elevations, and distinguishes the effects of various OCP types on blood pressure. Finally, it describes current recommendations regarding hypertension and OCP use, as well as identifies strategies, such as over-the-counter OCP prescribing, to safely and equitably improve access to oral contraception. |
| Author | Bello, Natalie A. Cameron, Natalie A. Blyler, Ciantel A. |
| AuthorAffiliation | Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (C.A.B., N.A.B.) Northwestern University Feinberg School of Medicine, Department of Medicine, Division of General Internal Medicine, Chicago, IL (N.A.C.) |
| AuthorAffiliation_xml | – name: Northwestern University Feinberg School of Medicine, Department of Medicine, Division of General Internal Medicine, Chicago, IL (N.A.C.) – name: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (C.A.B., N.A.B.) – name: 1 Northwestern University Feinberg School of Medicine, Department of Medicine, Division of General Internal Medicine, Chicago, Illinois – name: 2 Department of Cardiology Smidt Heart Institute Cedars-Sinai Medical Center, Los Angeles, California |
| Author_xml | – sequence: 1 givenname: Natalie A. surname: Cameron fullname: Cameron, Natalie A. organization: Northwestern University Feinberg School of Medicine, Department of Medicine, Division of General Internal Medicine, Chicago, IL (N.A.C.) – sequence: 2 givenname: Ciantel A. surname: Blyler fullname: Blyler, Ciantel A. organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (C.A.B., N.A.B.) – sequence: 3 givenname: Natalie A. surname: Bello fullname: Bello, Natalie A. organization: Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (C.A.B., N.A.B.) |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37075131$$D View this record in MEDLINE/PubMed |
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| Snippet | Oral contraceptive pills (OCPs) have been used as effective and popular forms of contraception since the middle of the last century. By 2019, over 150 million... |
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| SubjectTerms | Adult Blood Pressure Contraception - adverse effects Contraceptives, Oral - adverse effects Female Humans Hypertension - epidemiology Pregnancy |
| Title | Oral Contraceptive Pills and Hypertension: A Review of Current Evidence and Recommendations |
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