Mann J I
Am J Obstet Gynecol. 1982 Mar 15;142(6 Pt 2):752-7. doi: 10.1016/s0002-9378(16)32483-8.
Earlier publications on the cardiovascular risks associated with oral contraceptive use emphasized the role of estrogens. Today most oral contraceptives contain less tha 50 microgram of estrogen. Furthermore, prescribing practices have improved so that most women with risk factors are not taking oral contraceptives. No differences in risk of fatal myocardial infarctions could be demonstrated by women taking 50 microgram estrogen products versus those taking products with lower estrogen dosages. Perhaps this result reflects small numbers of patients in the study, or perhaps it reflects an effect of progestogen. Since the lower estrogen doses are associated with levonorgestrel, the possibility exists that the advantages of reduced estrogen dosage are masked by the progestogen effect. A larger study is required to examine the relative importance of the estrogen and progestogen components in combined oral contraceptives.
早期关于口服避孕药相关心血管风险的出版物强调了雌激素的作用。如今，大多数口服避孕药含有的雌激素少于50微克。此外，处方做法已经改进，因此大多数有风险因素的女性不再服用口服避孕药。服用含50微克雌激素产品的女性与服用雌激素剂量较低产品的女性相比，在致命性心肌梗死风险方面未显示出差异。也许这一结果反映了研究中患者数量较少，或者也许它反映了孕激素的作用。由于较低的雌激素剂量与左炔诺孕酮有关，因此存在雌激素剂量降低的优势被孕激素作用掩盖的可能性。需要进行更大规模的研究来考察复方口服避孕药中雌激素和孕激素成分的相对重要性。
