The oral contraceptive pill (OCP) is widely prescribed throughout the world. Although it is associated with a small but significant increase in blood pressure, the influence of the OCP on large artery stiffness and wave reflection is unclear. The aim of this study was to determine the relationship between use of the OCP and aortic stiffness and wave reflections in a young, healthy cohort of women.
Methods
Participants were drawn from the ENIGMA study, which examines the natural history of blood pressure in young adults. A detailed medical history and lifestyle questionnaire, including OCP details were taken. Blood pressure was measured according to the British Hypertension Society guidelines. Aortic pulse wave velocity (aPWV) was measured together with augmentation index (AIx). Stroke volume (SV) and cardiac output (CO) were also assessed.
Results
Women taking the OCP (n = 225) had a higher SBP and pulse pressure compared with nonusers (n = 660; 112 ± 12 vs. 110 ± 11 and 43 ± 8 vs. 42 ± 8 mmHg, respectively, P < 0.05 for both). CO and SV were also higher (6.6 ± 1.5 vs. 6.3 ± 1.5 l/min, P < 0.01 and 81 ± 16 vs. 78 ± 19 ml, P < 0.05) as was aPWV (5.5 ± 0.7 vs. 5.4 ± 0.7 m/s, P < 0.05). However, there was no difference in DBP (68 ± 9 vs. 69 ± 9 mmHg), mean arterial pressure (81 ± 10 vs. 81 ± 10 mmHg) or AIx (2 ± 12 vs. 3 ± 13%) between the groups.
Conclusion
Use of the OCP is associated with elevated pulse pressure and SV and a small increase in aPWV in young women. The longer term implications of these effects require further investigation.
oral contraceptive pill arterial stiffness young women, hormonal contraception aortic pulse wave velocity blood pressure, oral contraceptive cardiovascular risk arterial stiffness ENIGMA study, OCP use increased pulse pressure stroke volume young women, oral contraceptive pill large artery stiffness augmentation index, hormonal contraceptive cardiovascular effects blood pressure young adults, oral contraceptive cardiac output systolic blood pressure increase, aortic pulse wave velocity oral contraceptive users vs nonusers, long term cardiovascular implications oral contraceptive pill use, contraceptive side effects vascular stiffness hemodynamic changes
PMID 21505350 21505350 DOI 10.1097/HJH.0b013e328346a5af 10.1097/HJH.0b013e328346a5af
Cite this article
Hickson, S. S., Miles, K. L., McDonnell, B. J., Yasmin, Cockcroft, J. R., Wilkinson, I. B., McEniery, C. M., & ENIGMA Study Investigators (2011). Use of the oral contraceptive pill is associated with increased large artery stiffness in young women: the ENIGMA study. *Journal of hypertension*, *29*(6), 1155-1159. https://doi.org/10.1097/HJH.0b013e328346a5af
Hickson SS, Miles KL, McDonnell BJ, Yasmin, Cockcroft JR, Wilkinson IB, et al. Use of the oral contraceptive pill is associated with increased large artery stiffness in young women: the ENIGMA study. J Hypertens. 2011;29(6):1155-1159. doi:10.1097/HJH.0b013e328346a5af
Hickson, S. S., et al. "Use of the oral contraceptive pill is associated with increased large artery stiffness in young women: the ENIGMA study." *Journal of hypertension*, vol. 29, no. 6, 2011, pp. 1155-1159.
Background: Over 100 million women currently use oral contraceptive pills (OCPs) worldwide. However, little is known about the effects of OCPs on arterial stiffness and hemodynamics. Furthermore, whet...