Data show potential cardioprotective effects of birth control use
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Key takeaways:
- Researchers observed a small net benefit of birth control use on risk for all-cause death and CVD events.
- The protective effects were stronger in women who reported longer duration of use.
A large analysis of UK Biobank data indicated no increased CV risk from birth control and even suggested a potential cardioprotective effect from oral contraceptive use, researchers reported.
Additionally, women who reported longer duration use may experience lower risk for CVD events compared with shorter duration or never users of oral contraceptives, according to data published in the Journal of the American Heart Association.
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“Oral contraceptives are widely used as the contraception method in women of reproductive age worldwide. The risk of CVD with the use of oral hormonal contraception is an important scientific issue,” Weijuan Dou, MD, of the department of endocrinology and metabolism at Nanfang Hospital, Southern Medical University, Guangzhou, China, and colleagues wrote. “Previous evidence that use of oral contraceptives was associated with the risk of CVD events was mainly limited among users of second-generation oral contraceptives, whereas the risk of third-generation oral contraceptives was still unclear. ... To our knowledge, prospective high-quality evidence focusing on the relationships between oral contraceptive use with CVD and death in the large-scale general population is scarce.”
Using the UK Biobank cohort, Dou and colleagues identified 161,017 women with no CVD at baseline and reported their oral contraceptive use from 2006 to 2010 (mean age, 54 years; 93.2% white individuals; 49% with college or university degree).
Participants were classified as either ever users or never users.
The main outcomes included total CVD events, specific CVD events, CVD death and all-cause death.
Birth control use and risk for CVD events
Overall, 81.4% of the cohort reported oral contraceptive use at baseline.
Compared with never use, researchers observed that ever use of oral contraceptives was not associated with increased risk and may even be protective of all-cause death (adjusted HR = 0.92; 95% CI, 0.86-0.99; P = .026), incident CVD events (aHR = 0.91; 95% CI, 0.87-0.96; P = .001) and specific CVD events including CHD (aHR = 0.88; 95% CI, 0.81-0.95; P < .001), HF (aHR = 0.87; 95% CI, 0.76-0.99; P = .043) and atrial fibrillation (aHR = 0.92; 95% CI, 0.84-0.99; P = .049).
There was no significant association between oral contraceptive use and risk for CVD death (aHR = 0.94; 95% CI, 0.81-1.09; P = .4), MI (aHR = 0.89; 95% CI, 0.76-1.03; P = .124) or stroke (aHR = 1.03; 95% CI, 0.91-1.18; P = .625), according to the study.
Moreover, associations between oral contraceptive use and reduced risk for CVD events were stronger among participants with longer durations of use (P for trend < .001).
Data may ‘shift in public perception’ of birth control
“Our findings suggest that oral contraceptive use was not associated with an increased risk of CVD events and all-cause death in women and may even produce an apparent net benefit. In addition, the beneficial effects appeared to be more apparent in participants with longer durations of use,” the researchers wrote. “These findings provide significant public health insights and may facilitate a shift in public perception because oral contraceptive use is common in women of reproductive age, and previously negative publicity exists about the safety of oral contraceptive use. Future studies are needed to determine the appropriate formulations or dosages of oral contraceptives on CVD outcomes in larger-scale prospective studies.”
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