Relationship between the Use of Hormonal Contraceptives and the Promotion of Changes in Hemodynamic Factors that Predispose to Cardiovascular Risk
The use of hormonal contraceptive drugs is widely used in different age groups, mainly due to easy acquisition and due to a large number of prescriptions. Besides, several studies point to the high cardiovascular risk concerning the use of hormonal contraceptives. In this study, we evaluated 620 Brazilian women to demonstrate the correlation between the hormonal contraceptives uses with the increase of the predisposition of risk for cardiovascular diseases. Our data demonstrated that concomitant use of contraceptives showed a significant reduction activated partial thromboplastin time and prothrombin time similar to hypercoagulability clinical conditions. Besides, as a compensation mechanism, there was an increase in the Fibrinogen levels. We also verified a significant increase at the total cholesterol and platelet aggregation up to 10%. Therefore, it was evidenced through this study that the use of hormonal contraceptives may increase cardiovascular risk. Besides, our data represents an alert since, in Brazil, the primary contraceptive hormone prescribed in public health units consists of second-generation drugs, which are the ones that most present associations with cardiovascular risk.
[1] Dias TM, Bonan C, Nakano AR, Maksud I, Teixeira LA. “Estará nas
pílulas anticoncepcionais a solução?” Debate na mídia entre 1960-
1970. Rev Estud Fem. 2018;26(3):1–19.
[2] Harper JC. Use of Oral Contraceptives for Management of Acne
Vulgaris: Practical Considerations in Real World Practice. Dermatol
Clin. 2016;34(2):159–65.
[3] Médicas FDEC. Kleber Cursino de Andrade Avaliação de parâmetros
metabólicos e marcadores de doença. 2018;
[4] Bonassi R, Magalhães J, Melo L, Maia H. Anticonceptivos orales
combinados en régimen extendido. Lilacs [Internet]. 2011; Available
from: http://files.bvs.br/upload/S/0100-7254/2011/v39n10/a2961.pdf
[5] Blakely KK. A New Year-Long Combination Hormonal
Contraceptive. Nurs Womens Health [Internet]. 2019;23(2):172–6.
Available from: https://doi.org/10.1016/j.nwh.2019.01.008
[6] Farias AGDS, Lima ACS, Brasil RFG, Moura ERF, Cunha M da
CDSO, Melo FMDS. Uso seguro de anticoncepcionais hormonais
injetáveis segundo critérios médicos de elegibilidade / Safe use of
injectable hormonal contraceptives according to medical eligibility
criteria. Rev Pesqui Cuid é Fundam Online. 2018;10(2):368.
[7] Tavares Padovan F, Freitas G. Anticoncepcional Oral Associado Ao
Risco De Trombose Venosa Profunda Oral Contraceptive That Is
Associated With the Risk of Deep Vein Thrombosis. Brazilian J Surg
Clin Res -BJSCR [Internet]. 2014;9(1):73–7. Available from:
http://www.mastereditora.com.br/bjscr
[8] Santana JR, Waisse S. Chegada e difusão da pílula anticoncepcional
no Brasil, 1962-1972: qual informação foi disponibilizada às usuárias
potenciais ? Rev Bras História da Ciência [Internet]. 2016;9(2):203–
18. Available from:
http://www.sbhc.org.br/revistahistoria/view?ID_REVISTA_HISTORI
A=57
[9] Brito MB, Nobre F, Vieira CS. Clinical Update Hormonal
Contraception and Cardiovascular System. Arq Bras Cardiol
[Internet]. 2011;95(4):81–8. Available from: http://www.scielo.br/
[10] Machado RB, de Melo NR, Maia H, Cruz AM. Effect of a continuous
regimen of contraceptive combination of ethinylestradiol and
drospirenone on lipid, carbohydrate and coagulation profiles.
Contraception [Internet]. 2010;81(2):102–6. Available from:
http://dx.doi.org/10.1016/j.contraception.2009.08.009
[11] Sonou A, Ogoudjobi M, Adjagba PM, Houehanou C, Aniglé R, Codjo
L, et al. Absolute cardiovascular risk of women using hormonal
contraception in Porto-Novo. Cardiovasc J Afr [Internet]. 2018 [cited
2019 May 30];29(2):e1–4. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/29583149
[12] Asare GA, Santa S, Ngala RA, Asiedu B, Afriyie D, Amoah AG.
Effect of hormonal contraceptives on lipid profile and the risk indices
for cardiovascular disease in a Ghanaian community. Int J Womens
Health [Internet]. 2014 [cited 2019 May 30];6:597–603. Available
from: http://www.ncbi.nlm.nih.gov/pubmed/24940082
[13] Sousa IC de A de, Álvares A da CM. A Trombose Venosa Profunda
Como Reação Adversa Do Deep Venous Thrombosis As an Adverse
Reaction of Continuous Use of Oral Contraceptives. Rev Cient.
2018;7(1):54–65.
[14] Brandt GP, Rodrigues De Oliveira AP, Burci LM. Anticoncepcionais
Hormonais Na Atualidade: Um Novo Paradigma Para O Planejamento
Familiar Hormonal Contraceptives Today, a New Paradigm for
Family Planning. Rev Gestão Saúde [Internet]. 2018;18(1):54–62.
Available from:
http://www.herrero.com.br/files/revista/fileffb43b6252282b433e193b
acf91d43f7.pdf
[15] Silva MAD da, Sousa AGMR, Schargodsky H. Fatores de Risco para
Infarto do Miocárdio no Brasil. Arq Bras Cardiol. 1998;71(5):667–75.
[16] Rech CR, Petroski EL, Da Silva RCR, Da Silva JCN. Indicadores
antropométricos de excesso de gordura corporal em mulheres. Rev
Bras Med do Esporte. 2006;12(3):119–24.
[17] Barbaresko J, Rienks J, Nöthlings U. Lifestyle Indices and
Cardiovascular Disease Risk: A Meta-analysis. Am J Prev Med.
2018;55(4):555–64.
[18] Donma O, Donma MM. An Indispensable Parameter in Lipid Ratios
to Discriminate between Morbid Obesity and Metabolic Syndrome in
Children : High Density Lipoprotein Cholesterol. 2018;(5).
[19] Beller JP, McCartney CR. Cardiovascular risk and combined oral
contraceptives: Clinical decisions in settings of uncertainty. Am J
Obstet Gynecol [Internet]. 2013;208(1):39–41. Available from:
http://dx.doi.org/10.1016/j.ajog.2012.01.037
[20] Vos A, Kockelkoren R, de Vis JB, van der Schouw YT, van der
Schaaf IC, Velthuis BK, et al. Risk factors for atherosclerotic and
medial arterial calcification of the intracranial internal carotid artery.
Atherosclerosis. 2018;276:44–9.
[21] Hennessey CA, Patel VK, Tefera EA, Gomez-Lobo V. Venous
Thromboembolism in Female Adolescents: Patient Characteristics. J
Pediatr Adolesc Gynecol [Internet]. 2018;31(5):503–8. Available
from: https://doi.org/10.1016/j.jpag.2018.06.007
[22] Horton LG, Simmons KB, Curtis KM. Combined hormonal
contraceptive use among obese women and risk for cardiovascular
events: A systematic review. Contraception [Internet].
2016;94(6):590–604. Available from:
http://dx.doi.org/10.1016/j.contraception.2016.05.014
[23] Romero A, Alonso C, Rincón M, Medrano J, Santos JM, Calderón E,
et al. Risk of venous thromboembolic disease in women: A qualitative
systematic review. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):8–
17.
[24] Serfaty D. Update on the contraceptive contraindications. J Gynecol
Obstet Hum Reprod [Internet]. 2019;48(5):297–307. Available from:
https://doi.org/10.1016/j.jogoh.2019.02.006
[25] Sood S, Stein S, Konkle BA. Thrombotic Risk of Contraceptives and
Other Hormonal Therapies [Internet]. Fourth Edi. Consultative
Hemostasis and Thrombosis. Elsevier Inc.; 2009. 567–580 p.
Available from: https://doi.org/10.1016/B978-0-323-46202-0.00031-5
[26] Shufelt CL, Bairey Merz CN. Contraceptive Hormone Use and
Cardiovascular Disease. J Am Coll Cardiol [Internet].
2009;53(3):221–31. Available from:
http://dx.doi.org/10.1016/j.jacc.2008.09.042
[1] Dias TM, Bonan C, Nakano AR, Maksud I, Teixeira LA. “Estará nas
pílulas anticoncepcionais a solução?” Debate na mídia entre 1960-
1970. Rev Estud Fem. 2018;26(3):1–19.
[2] Harper JC. Use of Oral Contraceptives for Management of Acne
Vulgaris: Practical Considerations in Real World Practice. Dermatol
Clin. 2016;34(2):159–65.
[3] Médicas FDEC. Kleber Cursino de Andrade Avaliação de parâmetros
metabólicos e marcadores de doença. 2018;
[4] Bonassi R, Magalhães J, Melo L, Maia H. Anticonceptivos orales
combinados en régimen extendido. Lilacs [Internet]. 2011; Available
from: http://files.bvs.br/upload/S/0100-7254/2011/v39n10/a2961.pdf
[5] Blakely KK. A New Year-Long Combination Hormonal
Contraceptive. Nurs Womens Health [Internet]. 2019;23(2):172–6.
Available from: https://doi.org/10.1016/j.nwh.2019.01.008
[6] Farias AGDS, Lima ACS, Brasil RFG, Moura ERF, Cunha M da
CDSO, Melo FMDS. Uso seguro de anticoncepcionais hormonais
injetáveis segundo critérios médicos de elegibilidade / Safe use of
injectable hormonal contraceptives according to medical eligibility
criteria. Rev Pesqui Cuid é Fundam Online. 2018;10(2):368.
[7] Tavares Padovan F, Freitas G. Anticoncepcional Oral Associado Ao
Risco De Trombose Venosa Profunda Oral Contraceptive That Is
Associated With the Risk of Deep Vein Thrombosis. Brazilian J Surg
Clin Res -BJSCR [Internet]. 2014;9(1):73–7. Available from:
http://www.mastereditora.com.br/bjscr
[8] Santana JR, Waisse S. Chegada e difusão da pílula anticoncepcional
no Brasil, 1962-1972: qual informação foi disponibilizada às usuárias
potenciais ? Rev Bras História da Ciência [Internet]. 2016;9(2):203–
18. Available from:
http://www.sbhc.org.br/revistahistoria/view?ID_REVISTA_HISTORI
A=57
[9] Brito MB, Nobre F, Vieira CS. Clinical Update Hormonal
Contraception and Cardiovascular System. Arq Bras Cardiol
[Internet]. 2011;95(4):81–8. Available from: http://www.scielo.br/
[10] Machado RB, de Melo NR, Maia H, Cruz AM. Effect of a continuous
regimen of contraceptive combination of ethinylestradiol and
drospirenone on lipid, carbohydrate and coagulation profiles.
Contraception [Internet]. 2010;81(2):102–6. Available from:
http://dx.doi.org/10.1016/j.contraception.2009.08.009
[11] Sonou A, Ogoudjobi M, Adjagba PM, Houehanou C, Aniglé R, Codjo
L, et al. Absolute cardiovascular risk of women using hormonal
contraception in Porto-Novo. Cardiovasc J Afr [Internet]. 2018 [cited
2019 May 30];29(2):e1–4. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/29583149
[12] Asare GA, Santa S, Ngala RA, Asiedu B, Afriyie D, Amoah AG.
Effect of hormonal contraceptives on lipid profile and the risk indices
for cardiovascular disease in a Ghanaian community. Int J Womens
Health [Internet]. 2014 [cited 2019 May 30];6:597–603. Available
from: http://www.ncbi.nlm.nih.gov/pubmed/24940082
[13] Sousa IC de A de, Álvares A da CM. A Trombose Venosa Profunda
Como Reação Adversa Do Deep Venous Thrombosis As an Adverse
Reaction of Continuous Use of Oral Contraceptives. Rev Cient.
2018;7(1):54–65.
[14] Brandt GP, Rodrigues De Oliveira AP, Burci LM. Anticoncepcionais
Hormonais Na Atualidade: Um Novo Paradigma Para O Planejamento
Familiar Hormonal Contraceptives Today, a New Paradigm for
Family Planning. Rev Gestão Saúde [Internet]. 2018;18(1):54–62.
Available from:
http://www.herrero.com.br/files/revista/fileffb43b6252282b433e193b
acf91d43f7.pdf
[15] Silva MAD da, Sousa AGMR, Schargodsky H. Fatores de Risco para
Infarto do Miocárdio no Brasil. Arq Bras Cardiol. 1998;71(5):667–75.
[16] Rech CR, Petroski EL, Da Silva RCR, Da Silva JCN. Indicadores
antropométricos de excesso de gordura corporal em mulheres. Rev
Bras Med do Esporte. 2006;12(3):119–24.
[17] Barbaresko J, Rienks J, Nöthlings U. Lifestyle Indices and
Cardiovascular Disease Risk: A Meta-analysis. Am J Prev Med.
2018;55(4):555–64.
[18] Donma O, Donma MM. An Indispensable Parameter in Lipid Ratios
to Discriminate between Morbid Obesity and Metabolic Syndrome in
Children : High Density Lipoprotein Cholesterol. 2018;(5).
[19] Beller JP, McCartney CR. Cardiovascular risk and combined oral
contraceptives: Clinical decisions in settings of uncertainty. Am J
Obstet Gynecol [Internet]. 2013;208(1):39–41. Available from:
http://dx.doi.org/10.1016/j.ajog.2012.01.037
[20] Vos A, Kockelkoren R, de Vis JB, van der Schouw YT, van der
Schaaf IC, Velthuis BK, et al. Risk factors for atherosclerotic and
medial arterial calcification of the intracranial internal carotid artery.
Atherosclerosis. 2018;276:44–9.
[21] Hennessey CA, Patel VK, Tefera EA, Gomez-Lobo V. Venous
Thromboembolism in Female Adolescents: Patient Characteristics. J
Pediatr Adolesc Gynecol [Internet]. 2018;31(5):503–8. Available
from: https://doi.org/10.1016/j.jpag.2018.06.007
[22] Horton LG, Simmons KB, Curtis KM. Combined hormonal
contraceptive use among obese women and risk for cardiovascular
events: A systematic review. Contraception [Internet].
2016;94(6):590–604. Available from:
http://dx.doi.org/10.1016/j.contraception.2016.05.014
[23] Romero A, Alonso C, Rincón M, Medrano J, Santos JM, Calderón E,
et al. Risk of venous thromboembolic disease in women: A qualitative
systematic review. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):8–
17.
[24] Serfaty D. Update on the contraceptive contraindications. J Gynecol
Obstet Hum Reprod [Internet]. 2019;48(5):297–307. Available from:
https://doi.org/10.1016/j.jogoh.2019.02.006
[25] Sood S, Stein S, Konkle BA. Thrombotic Risk of Contraceptives and
Other Hormonal Therapies [Internet]. Fourth Edi. Consultative
Hemostasis and Thrombosis. Elsevier Inc.; 2009. 567–580 p.
Available from: https://doi.org/10.1016/B978-0-323-46202-0.00031-5
[26] Shufelt CL, Bairey Merz CN. Contraceptive Hormone Use and
Cardiovascular Disease. J Am Coll Cardiol [Internet].
2009;53(3):221–31. Available from:
http://dx.doi.org/10.1016/j.jacc.2008.09.042
@article{"International Journal of Medical, Medicine and Health Sciences:79561", author = "Camila Cássia Canzi and Camila Lima and Lucas Pereira and Jussana Araújo and Manoella Porto Castro and Silvio Terra Stefanello and Leandro Dobrachinski", title = "Relationship between the Use of Hormonal Contraceptives and the Promotion of Changes in Hemodynamic Factors that Predispose to Cardiovascular Risk", abstract = "The use of hormonal contraceptive drugs is widely used in different age groups, mainly due to easy acquisition and due to a large number of prescriptions. Besides, several studies point to the high cardiovascular risk concerning the use of hormonal contraceptives. In this study, we evaluated 620 Brazilian women to demonstrate the correlation between the hormonal contraceptives uses with the increase of the predisposition of risk for cardiovascular diseases. Our data demonstrated that concomitant use of contraceptives showed a significant reduction activated partial thromboplastin time and prothrombin time similar to hypercoagulability clinical conditions. Besides, as a compensation mechanism, there was an increase in the Fibrinogen levels. We also verified a significant increase at the total cholesterol and platelet aggregation up to 10%. Therefore, it was evidenced through this study that the use of hormonal contraceptives may increase cardiovascular risk. Besides, our data represents an alert since, in Brazil, the primary contraceptive hormone prescribed in public health units consists of second-generation drugs, which are the ones that most present associations with cardiovascular risk.", keywords = "fibrinogen, cardiovascular diseases, hormonal contraceptives, woman
", volume = "14", number = "4", pages = "116-5", }
