Birth Control Pills Don’t Increase Risk of Heart Attack for Non-Smokers

Women who currently take or have taken oral contraceptives (OCs) are no more likely to have a heart attack than women who do not take them, according to a study appearing in the April 23 issue of the journal Archives of Internal Medicine.

Reports linking use of OCs to heart attack first surfaced soon after birth control pills were first approved in the 1960s. The early forms of OCs all contained more than 50 micrograms of estrogen. Over the years, however, OC manufacturers have progressively devised new formulations containing lower estrogen doses. The current study, led by Lynn Rosenberg, ScD of the Slone Epidemiology Unit of the Boston University School of Public Health, assesses whether use of lower dose OCs (between 20 and 50 micrograms of estrogen) increases a woman’s risk of heart attack.

From 1985 through 1998 Rosenberg and colleagues identified women under age 45 who had been admitted with a heart attack to one of 75 participating hospitals in the greater Philadelphia and Boston areas. The women were then interviewed with standard questionnaires about OC use and other risk factors for heart attack such as smoking, cholesterol level, and high blood pressure. In all, 627 women admitted for heart attack were studied.

For a control group, the researchers selected 2947 women less than 45 years old, who had been admitted to the hospital for reasons unrelated to heart attack. These women answered the same questionnaire as the heart attack patients. The researchers then compared OC use and smoking for women who suffered a heart attack with those who did not.

The researchers found that current use of low dose OCs did not increase a non-smoking woman’s risk of heart attack. This result was independent of past OC use, duration of current OC use, and type of OC formulation.

Compared to women who do not smoke, smokers — both those who use or do not use OCs — had much higher chances of having a heart attack; this fact is well known to medical science. The researchers found that women who smoke 24 or fewer cigarettes per day were 4 times as likely to have a heart attack, while those who light up more than 24 times per day increased their risk 12 fold. For women who smoke up to 24 cigarettes per day this risk was not further increased by current OC use. However, women who smoke more than 24 cigarettes per day and take OCs were found to be over 30 times more likely than non-smokers to have a heart attack.

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