Perol Sandrine, Hugon-Rodin Justine, Plu-Bureau Geneviève
Hôpital Cochin Port-Royal, unité de gynécologie médicale, 75014 Paris, France.
Hôpital Cochin Port-Royal, unité de gynécologie médicale, 75014 Paris, France.
Presse Med. 2019 Nov;48(11 Pt 1):1269-1283. doi: 10.1016/j.lpm.2019.07.033. Epub 2019 Nov 19.
Hypertension is a major risk factor for cardiovascular diseases. Because of the high frequency of hormonal contraceptives use, assessing their side effects is an important public health issue. In this perspective, we conducted a review of the risk of hypertension associated with the use of hormonal contraceptives, either combined estrogen-progestin or only progestin. The use of combined hormonal contraceptives, regardless of its type and route of administration, is associated with a slight increase in blood pressure, both systolic and diastolic blood pressures. The frequency of onset of hypertension in women who use combined hormonal contraception is between 0.6% and 8.5%. Progestin-only contraception seems safe with respect to the risk of hypertension. It is therefore important to remember that the use of combined hormonal contraception is contra-indicated in hypertensive women, even well controlled. Finally, we propose a prescription assistance algorithm according to the recommendations of an expert panel. It should be remembered that taking blood pressure at each contraceptive consultation (initial and follow-up) is essential.
高血压是心血管疾病的主要危险因素。由于激素避孕药的使用频率很高，评估其副作用是一个重要的公共卫生问题。从这个角度来看，我们对使用激素避孕药（联合雌激素 - 孕激素或仅使用孕激素）相关的高血压风险进行了综述。无论联合激素避孕药的类型和给药途径如何，其使用都与收缩压和舒张压的轻微升高有关。使用联合激素避孕的女性中高血压的发病频率在0.6%至8.5%之间。仅使用孕激素避孕在高血压风险方面似乎是安全的。因此，重要的是要记住，即使血压控制良好，高血压女性也禁忌使用联合激素避孕。最后，我们根据专家小组的建议提出了一种处方辅助算法。应该记住，在每次避孕咨询（初次和随访）时测量血压至关重要。
