Possible Heart Risks Due To Long-Term Pill Use

Over the years, about 100 million women worldwide are taking oral contraceptives with high estrogen content. Most of these pills, which were first sold in 1960, combine synthetic estrogen and progestin in various doses and are known to carry a small risk of blood clots and high blood pressure.
One small study from Belgium suggests that long-term use of oral contraceptives might increase the chances of having artery build-ups that can raise the risk of heart disease. Although the study needs further rigorous testing, it's importance can never be undermined due to the great number of women that are now taking the pill.
However, Dr. JoAnn Manson, chief of preventive medicine at Harvard-affiliated Brigham and Women's Hospital in Boston thinks that this theory should not cause any alarm among women. And while she had no role in the new study, which was presented Tuesday at an American Heart Association conference in Florida, she cited that many previous studies have found no large increase in heart attacks among pill users. Manson added that since they are already known to carry a small risk of blood clots and high blood pressure for women currently taking them, and any additional heart attack or stroke risk is thought to be related to those two effects.
In a long-running observational study in the small town of Erpe-Mere, researchers at the University of Ghent in Belgium studied about 1,300 healthy women ages 35 to 55 to look for other signs of heart risks among past and current pill users. According to Dr. Ernst Rietzschel, the study's chief researcher, about 81 percent had taken oral contraceptives for more than a year at some point in their lives. The results of the Belgian study ran very close to the findings of the U.S. Centers for Disease Control and Prevention that undertook a similar study on American women ages 15 to 44.
Ultrasound exams were done of arteries in their necks and legs to look for buildups called plaque. There was a 20 to 30 percent increased prevalence of plaque for every 10 years of oral contraceptive use. While the plaques may be small enough not to block an an artery, any plaque is thought to raise the risk of heart disease. However, researchers admitted that they have no information on whether the presence of plaque translated to any true risk of heart attacks or strokes in the group.
Several women in the study had taken first-generation birth control pills, which had twice the estrogen levels compared with those sold in pharmacies today. And though the doses and length of continuous pill use matters a lot in terms of impact assessment, the Belgian researchers do not have enough detail or facts from which to base a definitive medical analysis, said Dr. Daniel Jones, a University of Mississippi cardiologist and president of the Heart Association.
“It could be an important study,” said Jones, which needs to be tested in larger and more rigorous studies wherein one group of women are given pills, another are not, and their health is closely watched for some time afterward.
Rietzschel assures women who are worried about heart risks that there is no need to abandon birth control pills but should follow guidelines for their use and avoid other things that raise heart risks, like smoking, being overweight, and lack of exercise.