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Momeni, Z., Dehghani, A., Fallahzadeh, H., Koohgardi, M., Dafei, M., & Mohammadi, M. (2019). Effects of low-dose contraceptive pills on the risk factors of cardiovascular diseases among 15-35-year-old women: A retrospective cohort. International Journal of Reproductive BioMedicine (IJRM), 17(10), 841–850. https://doi.org/10.18502/ijrm.v17i10.5496
https://doi.org/10.18502/ijrm.v17i10.5496
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Zahra Momeni
Zahra Momeni
Deputy of Health, Bushehr University of Medical Sciences, Bushehr, Iran; Department of Biostatistics and Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
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Ali Dehghani
Ali Dehghani
Department of Biostatistics and Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
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Hossein Fallahzadeh
Hossein Fallahzadeh
Department of Biostatistics and Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
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Moslem Koohgardi
Moslem Koohgardi
Department of Health Education and Health Promotion, Faculty of Health, Rafsanjan University of Medical Sciences and Health Services, Kerman, Iran
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Maryam Dafei
Maryam Dafei
Department of Midwifery, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
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Masoud Mohammadi
Masoud Mohammadi
Department of Nursing, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
Published Date
- Nov 28, 2019
Effects of low-dose contraceptive pills on the risk factors of cardiovascular diseases among 15-35-year-old women: A retrospective cohort
Abstract
Background: Cardiovascular diseases could be preventable; as a result, understanding the risk factors was regarded as the major priority for healthcare providers.
Objective: The main objective of this research was to achieve a deeper insight into the effect of long-term use of low-dose oral contraceptive pills (OCP) on the risk factors of cardiovascular diseases.
Materials and Methods: This research was a retrospective cohort conducted (historical and prospectively) conducted on 100 women with normal menstrual cycles aged 15 to 35 yr, who were referred to the healthcare centers in Yazd, Iran. The participants were categorized into two groups: The OCP group was consuming the pills for 3, 4-23, and 24-36 months, and the non-OCP group. Participants were followed up for a minimum of 3 months and a maximum of six months.
Results: The highest level of low-density lipoprotein (LDL), homocysteine, cholesterol, triglyceride levels, and systolic blood pressure was observed in the OCP group in the duration of 24 to 36 months. The Tukey’s test demonstrated that there were comprehensible differences in the LDL (p = 0.01), cholesterol (p = 0.01), triglyceride (p < 0.001), and homocysteine levels (p < 0.001), also systolic blood pressure (p = 0.04).
Conclusion: It was realized that the long-term consumption of low-dose OCP can augment the incidence of some risk factors (systolic blood pressure, homocysteine levels, cholesterol, LDL-c, and triglyceride) and lead to developing cardiovascular diseases amongst the healthy women.
Key words: Birth control pills, Homocysteine, Nitric oxide, Dyslipidemias, Coronary artery diseases.
References
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[2] Robbins CL, Farr SL, Zapata LB, D’Angelo DV, Callaghan WM. Postpartum contraceptive use among women with a recent preterm birth. Am J Obstet Gynecol 2015; 213: 508.e1–9.
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[11] Mirzaei N, Dehpour AR. Investigation of homocystein plasma level in cholestatic rat and its effect on nitric oxide secretion in liver. Sci J Hamadan Univ Med Sci 2005; 12: 25–34.
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[13] Merki-Feld GS, Imthurn B, Keller PJ. Effects of two oral contraceptives on plasma levels of nitric oxide, homocysteine, and lipid metabolism. Metabolism 2002; 51: 1216–1221.
[14] Mirershadi F, Faghihi M, Dehpour AR. Effect of endogenous nitric oxide on cardiac ischemic preconditioning in rat. Repository of Research and Investigative Information Hormozgan University of Medical Sciences 2009; 14: 13–21. (in Persian)
[15] Lussana F, Zighetti M, Bucciarelli P, Cugno M, Cattaneo M. Blood levels of homocysteine, folate, vitamin B6 and B12 in women using oral contraceptives compared to non-users. Thromb Res 2003; 112: 37– 41.
[16] Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Female hormones and thrombosis. Arterioscler Thromb Vasc Biol 2002; 22: 201–210.
[17] Akbarzadeh M, SHarifi N. Comparison of cardiovascular disease in women with OCP use and without OCP use in hospitals of Shiraz University of Medical Sciences. Iranian Journal of Nursing Research 2013; 8: 19–28.
[18] Tuchman E. Women’s injection drug practices in their own words: a qualitative study. Harm Reduct J 2015; 12: 6.
[19] Fallah S, Nouroozi V, Seifi M, Samadikuchaksaraei A, Aghdashi EM. Influence of oral contraceptive pills on homocysteine and nitric oxide levels: As risk factors for cardiovascular disease. J Clin Lab Anal 2012; 26: 120–123.
[20] Kumar A, Palfrey HA, Pathak R, Kadowitz PJ, Gettys TW, Murthy SN. The metabolism and significance of homocysteine in nutrition and health. Nutr Metab (Lond) 2017; 14: 78.
[21] Eslami A, Lotfaliany M, Akbarpour S, Azizi F, Hadaegh F. Trend of cardiovascular risk factors in the older Iranian population: 2002–2014. Geriatr Gerontol Int 2018; 18: 130–137.
[22] Esmaillzadeh A, Mirmiran P, Azizi F. Waist-to-hip ratio is a better screening measure for cardiovascular risk factors than other anthropometric indicators in Tehranian adult men. Int J Obes Relat Metab Disord 2004; 28: 1325–1332.
[23] Tohidi M, Assadi M, Dehghani Z, Vahdat K, Emami SR, Nabipour I. High sensitive C-reactive protein and ischemic heart disease, a population-based study. Iran South Med J 2012; 15: 253–262.
[24] Saw SM, Yuan JM, Ong CN, Arakawa K, Lee HP, Coetzee GA, et al. Genetic, dietary, and other lifestyle determinants of plasma homocysteine concentrations in middle-aged and older Chinese men and women in Singapore. Am J Clin Nutr 2001; 73: 232–239.
[25] Emokpae MA, Uadia PO, Osadolor HB. Effect of duration of use of hormonal contraceptive pills on total lipid and lipoproteins in Nigerian women. Int J Pharm Biol Sci 2010; 1: 1–5.
[26] Grossman D, Fuentes L. Over-the-counter access to oral contraceptives as a reproductive healthcare strategy. Curr Opin Obstet Gynecol 2013; 25: 500–505.
[27] Azizi F, Ainy E, Mirmiran P, Habibian S. Contraceptive methods and risk factors of cardiovascular diseases in Tehranian women: Tehran Lipid and Glucose Study. Eur J Contracept Reprod Health Care 2002; 7: 1–6.
[28] Lech MM, Ostrowska L. Effects of low-dose OCs on weight in women with central European nutritional habits and lifestyle. Contraception 2002; 66: 159–162.
[29] Pelkman CL, Chow M, Heinbach RA, Rolls BJ. Short - term effects of a progestational contraceptive drug on food intake, resting energy expenditure, and body weight in young women. Am J Clin Nutr 2001; 73: 19–26.
[30] Guazzelli CA, Lindsey PC, de Araújo FF, Barbieri M, Petta CA, Aldrighi JM. Evaluation of lipid profile in adolescents during long-term use of combined oral hormonal contraceptives. Contraception 2005; 71: 118–121.
[2] Robbins CL, Farr SL, Zapata LB, D’Angelo DV, Callaghan WM. Postpartum contraceptive use among women with a recent preterm birth. Am J Obstet Gynecol 2015; 213: 508.e1–9.
[3] Alonso de Lecinana M, Egido J. Estrogens as neuroprotectants against ischemic stroke. Cerebrovasc Dis 2006; 21 (Suppl.2): 48–53.
[4] Ribeiro CCM, Shimo AKK, Lopes MHBM, Lamas JLT. Effects of different hormonal contraceptives in women’s blood pressure values. Rev Bras Enferm 2018; 71 (suppl.3): 1453–1459.
[5] Sbarouni E, Kyriakides ZS, Kremastinos DT. The effect of hormone replacement therapy and simvastatin on plasma homocysteine. J Womens Health (Larchmt) 2005; 14: 154–158.
[6] Gupta M, Sharma P, Garg G, Kaur K, Bedi GK, Vij A. Plasma homocysteine: an independent or an interactive risk factor for coronary artery disease. Clin Chim Acta 2005; 352: 121–125.
[7] Vasan RS, Beiser A, D’Agostino RB, Levy D, Selhub J, Jacques PF, et al. Plasma homocysteine and risk for congestive heart failure in adults without prior myocardial infarction. JAMA 2003; 289: 1251–1257.
[8] Kannel WB. Overview of hemostatic factors involved in atherosclerotic cardiovascular disease. Lipids 2005; 40: 1215–1220.
[9] Serapinas D, Boreikaite E, Bartkeviciute A, Bandzeviciene R, Silkunas M, Bartkeviciene D. The importance of folate, vitamins B6 and B12 for the lowering of homocysteine concentrations for patients with recurrent pregnancy loss and MTHFR mutations. Reprod Toxicol 2017; 72: 159–163.
[10] Ardawi MS, Rouzi AA, Qari MH, Dahlawi FM, Al- Raddadi RM. Influence of age, sex, folate and vitamin B12 status on plasma homocysteine in Saudis. Saudi Med J 2002; 23: 959–968.
[11] Mirzaei N, Dehpour AR. Investigation of homocystein plasma level in cholestatic rat and its effect on nitric oxide secretion in liver. Sci J Hamadan Univ Med Sci 2005; 12: 25–34.
[12] Merki-Feld GS, Imthurn B, Keller PJ. Effects of two oral contraceptives on plasma levels of nitric oxide, homocysteine, and lipid metabolism. Metabolism 2002; 51: 1216–1221.
[13] Merki-Feld GS, Imthurn B, Keller PJ. Effects of two oral contraceptives on plasma levels of nitric oxide, homocysteine, and lipid metabolism. Metabolism 2002; 51: 1216–1221.
[14] Mirershadi F, Faghihi M, Dehpour AR. Effect of endogenous nitric oxide on cardiac ischemic preconditioning in rat. Repository of Research and Investigative Information Hormozgan University of Medical Sciences 2009; 14: 13–21. (in Persian)
[15] Lussana F, Zighetti M, Bucciarelli P, Cugno M, Cattaneo M. Blood levels of homocysteine, folate, vitamin B6 and B12 in women using oral contraceptives compared to non-users. Thromb Res 2003; 112: 37– 41.
[16] Rosendaal FR, Helmerhorst FM, Vandenbroucke JP. Female hormones and thrombosis. Arterioscler Thromb Vasc Biol 2002; 22: 201–210.
[17] Akbarzadeh M, SHarifi N. Comparison of cardiovascular disease in women with OCP use and without OCP use in hospitals of Shiraz University of Medical Sciences. Iranian Journal of Nursing Research 2013; 8: 19–28.
[18] Tuchman E. Women’s injection drug practices in their own words: a qualitative study. Harm Reduct J 2015; 12: 6.
[19] Fallah S, Nouroozi V, Seifi M, Samadikuchaksaraei A, Aghdashi EM. Influence of oral contraceptive pills on homocysteine and nitric oxide levels: As risk factors for cardiovascular disease. J Clin Lab Anal 2012; 26: 120–123.
[20] Kumar A, Palfrey HA, Pathak R, Kadowitz PJ, Gettys TW, Murthy SN. The metabolism and significance of homocysteine in nutrition and health. Nutr Metab (Lond) 2017; 14: 78.
[21] Eslami A, Lotfaliany M, Akbarpour S, Azizi F, Hadaegh F. Trend of cardiovascular risk factors in the older Iranian population: 2002–2014. Geriatr Gerontol Int 2018; 18: 130–137.
[22] Esmaillzadeh A, Mirmiran P, Azizi F. Waist-to-hip ratio is a better screening measure for cardiovascular risk factors than other anthropometric indicators in Tehranian adult men. Int J Obes Relat Metab Disord 2004; 28: 1325–1332.
[23] Tohidi M, Assadi M, Dehghani Z, Vahdat K, Emami SR, Nabipour I. High sensitive C-reactive protein and ischemic heart disease, a population-based study. Iran South Med J 2012; 15: 253–262.
[24] Saw SM, Yuan JM, Ong CN, Arakawa K, Lee HP, Coetzee GA, et al. Genetic, dietary, and other lifestyle determinants of plasma homocysteine concentrations in middle-aged and older Chinese men and women in Singapore. Am J Clin Nutr 2001; 73: 232–239.
[25] Emokpae MA, Uadia PO, Osadolor HB. Effect of duration of use of hormonal contraceptive pills on total lipid and lipoproteins in Nigerian women. Int J Pharm Biol Sci 2010; 1: 1–5.
[26] Grossman D, Fuentes L. Over-the-counter access to oral contraceptives as a reproductive healthcare strategy. Curr Opin Obstet Gynecol 2013; 25: 500–505.
[27] Azizi F, Ainy E, Mirmiran P, Habibian S. Contraceptive methods and risk factors of cardiovascular diseases in Tehranian women: Tehran Lipid and Glucose Study. Eur J Contracept Reprod Health Care 2002; 7: 1–6.
[28] Lech MM, Ostrowska L. Effects of low-dose OCs on weight in women with central European nutritional habits and lifestyle. Contraception 2002; 66: 159–162.
[29] Pelkman CL, Chow M, Heinbach RA, Rolls BJ. Short - term effects of a progestational contraceptive drug on food intake, resting energy expenditure, and body weight in young women. Am J Clin Nutr 2001; 73: 19–26.
[30] Guazzelli CA, Lindsey PC, de Araújo FF, Barbieri M, Petta CA, Aldrighi JM. Evaluation of lipid profile in adolescents during long-term use of combined oral hormonal contraceptives. Contraception 2005; 71: 118–121.