P J Schwingl1, H W Ory, C M Visness. 1. Family Health International, Biomedical Affairs Department, Research Triangle Park, Durham, North Carolina 27709, USA.
Abstract
OBJECTIVE: Our purpose was to estimate the annual risk of death in the United States from cardiovascular disease attributable to low-dose combination oral contraceptives. STUDY DESIGN: Estimates of the risk of death from cardiovascular disease attributable to low-dose oral contraceptives were modeled on data from studies published through 1997 and from age-specific mortality rates in the United States for 1993 and 1994. RESULTS: Attributable risk of death from cardiovascular disease resulting from oral contraceptive use is 0.06 and 3.0 per 100,000 nonsmokers 15 to 34 years of age and 35 to 44 years of age, respectively. In smokers this risk increases, respectively, to 1.73 and 19.4 per 100,000 users in these 2 age groups; however, 97% and 85% of this risk is due to the combined effects of smoking and using oral contraceptives. The attributable risk of death from cardiovascular disease in nonsmoking oral contraceptive users is lower than the risk of death from pregnancy in nonusers of oral contraceptives at all ages; however, among smoking oral contraceptive users more than 35 years of age, the excess risk of death from oral contraceptives is higher than the risk of death from pregnancy. CONCLUSION: There is virtually no excess attributable risk of death from cardiovascular disease related to oral contraceptive use in young women. However, smokers more than 35 years of age should use a nonestrogen contraceptive.
OBJECTIVE: Our purpose was to estimate the annual risk of death in the United States from cardiovascular disease attributable to low-dose combination oral contraceptives. STUDY DESIGN: Estimates of the risk of death from cardiovascular disease attributable to low-dose oral contraceptives were modeled on data from studies published through 1997 and from age-specific mortality rates in the United States for 1993 and 1994. RESULTS: Attributable risk of death from cardiovascular disease resulting from oral contraceptive use is 0.06 and 3.0 per 100,000 nonsmokers 15 to 34 years of age and 35 to 44 years of age, respectively. In smokers this risk increases, respectively, to 1.73 and 19.4 per 100,000 users in these 2 age groups; however, 97% and 85% of this risk is due to the combined effects of smoking and using oral contraceptives. The attributable risk of death from cardiovascular disease in nonsmoking oral contraceptive users is lower than the risk of death from pregnancy in nonusers of oral contraceptives at all ages; however, among smoking oral contraceptive users more than 35 years of age, the excess risk of death from oral contraceptives is higher than the risk of death from pregnancy. CONCLUSION: There is virtually no excess attributable risk of death from cardiovascular disease related to oral contraceptive use in young women. However, smokers more than 35 years of age should use a nonestrogen contraceptive.
Entities:
Keywords:
Age Factors--women; Americas; Behavior; Biology; Cardiovascular Effects--women; Cerebrovascular Effects--women; Contraception; Contraceptive Methods--side effects; Correlation Studies; Death Rate--women; Demographic Factors; Developed Countries; Diseases; Embolism; Excess Mortality--women; Family Planning; Heart Diseases; Mortality; Myocardial Infarction--women; North America; Northern America; Oral Contraceptives, Low-dose--side effects; Oral Contraceptives--side effects; Physiology; Population; Population Characteristics; Population Dynamics; Pulmonary Embolism--women; Research Methodology; Research Report; Risk Factors--women; Smoking--women; Statistical Studies; Studies; Thromboembolism--women; United States; Vascular Diseases; Women
Authors: Daniel Grossman; Kari White; Kristine Hopkins; Jon Amastae; Michele Shedlin; Joseph E Potter Journal: Obstet Gynecol Date: 2011-03 Impact factor: 7.661