Estimates of the risk of cardiovascular death attributable to low-dose oral contraceptives in the United States.
Am J Obstet Gynecol
; 180(1 Pt 1): 241-9, 1999 Jan.
Article
em En
| MEDLINE
| ID: mdl-9914611
ABSTRACT
PIP: The annual risk of death in the US from cardiovascular disease attributable to low-dose combination oral contraceptives (OCs) was estimated through use of data from studies published in 1980-1997 and from age-specific mortality rates for 1993 and 1994. Four cardiovascular disease categories were included: myocardial infarction, venous thromboembolism and pulmonary embolism, ischemic stroke, and hemorrhagic stroke. The overall risk of death from cardiovascular disease among nonsmoking users of low-dose OCs is 0.06/100,000 women in the 15-34 year age group and 3.03/100,000 women in the 35-44 year age group. For young nonsmokers, the excess mortality risk associated with OC use is smaller than the risk of death from pregnancy, whether terminated by abortion or carried to term. Among OC users who smoke, the risk of cardiovascular mortality is 1.73/100,000 in 15-34 year olds and 19.4/100,000 in women 35-44 years old; however, 97% and 85% of this risk, respectively, is composed of the combined OC-smoking risk. Among smoking OC users over 35 years of age, the excess risk of death from OCs exceeds the risk of death from pregnancy. Young nonsmokers raise their risk of death from cardiovascular disease by less than 10% (0.60-0.65/100,000) by using OCs, while young women who do not use OCs increase their risk of death by 260% (0.60-1.57/100,000) by smoking cigarettes. For older women, the corresponding increases are 95% among nonsmoking OC users and 315% among smoking nonusers. These estimates indicate that women over 35 years of age who smoke should not be permitted to use either low- or high-dose OCs because of the excess attributable risk of death from cardiovascular disease.
Palavras-chave
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
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Anticoncepcionais Orais
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Obstet Gynecol
Ano de publicação:
1999
Tipo de documento:
Article