[Arterial diseases in women using combined hormonal contraceptives].

OBJECTIVE

To determine the association between myocardial infarction and cerebral stroke and use of combined oral contraceptives.

DESIGN

Review of literature.

SETTING

Department of Obstetrics and Gynaecology, Hospital of Merciful Brothers, Brno, Czech Republic.

METHODS

Identification of methodologically sound studies able to address the topic. Studies were identified by Medline database search.

RESULTS

Five the most recent and important studies were the main source of information (Oxford Family Planning Association Contraception Study 1984, Royal College of General Practitioners' Study 1994, WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception 1996, 1997, Transnational Study on Oral Contraceptives and the Health of Young Women 1997, Myocardial Infarction and Oral Contraceptives Study, 1997). Generally there was no evidence of a significantly increased risk of arterial wall disease in healthy non smoked users younger than 35 years. No difference between second and third generation oral contraceptives on risk of arterial wall disease were found. In the most of cases of myocardial infarction or stroke one or more risk factor were identified. Two of the most relevant risk factors are smoking and the absence of blood pressure control.

CONCLUSION

The risk of arterial cardiovascular system diseases seems not to be increased at no-risk users (healthy non-smoker younger than 35 years).