Progestogen-only pills and high blood pressure: is there an association? A literature review.

The progestogen-only pill (POP) is a contraceptive option for women who have high blood pressure either induced by use of combined oral pills or due to other causes; as long as it is well controlled and monitored. Combined oral contraception (COC) and Depo-Provera have been implicated in increased cardiovascular risk following use. High blood pressure has been theorized to be the critical path that leads to this increased risk. POP is the recommended method for women who are at risk of coronary heart disease due to presence of risk factors like hypertension. In order to offer POP as a safe, alternative contraception to women who develop hypertension on COCs or those who are at increased cardiovascular risk, it is important to take into account evidence of no association of high blood pressure with POP use. A search of published medical literature (PUBMED and Cochrane database) was undertaken with this objective. A total of four articles were selected for final review after application of inclusion and exclusion criteria. Three of these were prospective control trials and one a cross-sectional survey. There was no randomized study to answer this question. The results of these studies consistently reported no significant association of high blood pressure with use of POPs for up to 2-3 years of follow-up.