Metabolic interrelationships, cardiovascular disease, and sex steroids

Third generation oral contraceptive use and cardiovascular risk factors

OBJECTIVE

To analyze the relationship between third generation oral contraceptive (OC) use and various cardiovascular risk factors--including markers of inflammation--in a population-based sample.

STUDY POPULATION AND METHODS

Data on OC use were obtained from women, aged 25-44 years participating in the MONICA Augsburg survey 1994-1995. Complete data were available from 841 women. Third generation OCs were defined as OCs containing desogestrel or gestodene, the remaining OC products were summarized in the group "other OC."

RESULTS

Women taking third generation OCs had significantly higher C-reactive protein, fibrinogen, plasma viscosity, and HDL-cholesterol concentrations compared to the "other OC" group and non-users. In contrast, LDL-cholesterol was identical in the three groups. The analyses of interaction between smoking and OC use revealed that smoking women taking third generation pills had a less favourable pattern concerning inflammatory markers compared to women not on OC or using other products.

CONCLUSION

Potentially harmful effects of OCs may arise from their positive association with the acute phase response. There is a close relationship with inflammatory markers in particular in women taking third generation OCs, which may, at least in part, contribute to the increased atherothrombotic risk, reported specifically in these women.