The Pill & Your Heart: What’s the Link?

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By Rachel Martin

A new study surprises researchers by showing that taking birth control pills could increase women's chances of developing arterial plaque, which may lead to heart problems.

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New research presented at the American Heart Association’s 2007 Scientific Sessions conference in November for the first time revealed a link between the use of oral contraceptives and an increase in arterial plaque, also known as atherosclerosis.
           
“Having atherosclerosis of any size is certainly indicative of a higher risk for future cardiovascular events,” says lead researcher Ernst Rietzschel, M.D., of Ghent University in Belgium.
           
Rietzschel and his team studied 1,300 healthy Belgian women 35 to 55 years of age. Approximately 81 percent of the women had taken oral contraceptives for a year or more (the average time spent on the pill was 13 years). In scanning the carotid and femoral arteries of the subjects, Rietzschel and his team were surprised to find that the prevalence of unilateral disease increased 17 percent in the carotid artery and 28 percent in the femoral artery for every 10 years of oral contraceptive use. The results suggest a 20–30 percent increase in the prevalence of plaque in the carotid and femoral arteries for every 10 years of oral contraceptive use. At this time, it isn’t clear why the pill has this effect.

More study needed
“In contrast to the data, research, and the knowledge about hormone replacement therapy, very little attention has been focused on oral contraceptives—a drug therapy that is taken by far more women, for far longer time frames, with far greater doses of estrogen,” Rietzschel says. “From a scientific point of view, the short-term goal should be confirmation of the data sets. And the second goal should be more research. It’s incredible that a drug that is being taken by 80 percent of women for more than 10 years is almost bereft of any long-term outcome data and safety data.”            

Use of oral contraceptives was already known to have some cardiovascular risk—particularly for smokers. Oral contraceptives elevate blood pressure by 4–9 mmHg, slightly decrease HDL (“good”) cholesterol, increase LDL (“bad”) cholesterol, and increase the risk for developing potentially life-threatening blood clots. What the Belgian study reveals, however, is that oral contraceptives can have long-term effects on the health of the arteries, which will affect the individual long after she has stopped taking the pill.