The Pill linked to atherosclerosis
The use of oral contraceptives (OC) is very common and associated with an unexpected increase in the prevalence of carotid and femoral atherosclerosis in young, apparently healthy women, according to a late-breaking trials session at the American Heart Association’s Scientific Sessions held in Orlando, Fla., this week.

Ernst Rietzschel, MD, department of cardiovascular diseases and department of public health, at Ghent University in Belgium, presented the results of the study.

Rietzschel cited from the United Nations Population Division to state that “combination therapy with the female hormones estrogen and progestin are among the most frequently used drugs in the world with approximately 100 million women taking OC.

Compared with hormone replacement therapy, OCs are “used by far more women for a far longer time and have far higher levels of estrogen,” noted Rietzschel at the press conference. Yet, he added that scientific literature is “almost bereft of long-term safety data on OCs.”

The study consisted of 2,524 apparently healthy women between the ages of 35 and 55 years old. OC usage was calculated from data provided by the participant, and validated by the primary care physician. The median OC exposure was 13 years, and 81 percent had taken OC for more than one year.

Rietzschel suggested that the rate of OC use in the United States is similar (82 percent) to the trial.

The results suggested a 20 to 30 percent increased prevalence of plaque in the carotid and femoral arteries per 10 years of OC exposure. Based on their findings, the researchers believe that in “light of widespread and usually prolonged OC use of more than 10 years, these results suggest that OC use could be an important factor in the global atherosclerotic burden.

“Oral contraceptives may not necessarily be the benign therapy we think they are. I don’t think we need to be alarmed, but we should be vigilant,” said Gordon Tomaselli, MD, chair of the AHA committee on scientific sessions program.

Both Rietzschel and Tomaselli emphasized that OC use is an individual choice, but that physicians should inform women of all their potential risks.