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

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Current Practice

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Currently, gynecologists prescribing oral contraceptives review each patient’s family history and strongly advise their patients not to smoke. Mary Jane Minkin, M.D., an obstetrician/gynecologist at Yale University School of Medicine in New Haven, Connecticut, says the research findings should not be cause for alarm.
           
“We have many years of experience with oral contraceptives, including significantly higher-dose pills, showing a really excellent safety profile. The first and foremost message is that smoking, older ages, and oral contraceptives are a lousy mix,” Minkin says. “And, of course, anyone who has a history of significant deep vein thrombophlebitis [blood clots] is a bad candidate for oral contraceptives. But for most other folks, the cardiovascular risks are pretty small.”
           
Other members of the medical community, including Rietzschel, were also quick to point out that this is the first study of its kind and that more research is needed on the use of oral contraceptives as well as other forms of birth control. In no way does this mean that women should stop using oral contraceptives, Rietzschel says, especially given that the cardiovascular risks of pregnancy are far greater.

Stay the course
Sharonne Hayes, M.D., cardiologist and director of the Women’s Heart Clinic at Mayo Clinic in Rochester, Minnesota, agrees with the cautionary stance of her fellow physicians.
           
“This study is provocative, because it raises new questions about the long-term safety of a widely used class of drugs,” Hayes says. “However, it is premature to change practice or our advice to patients.”
           
She points out that other studies on the long-term safety of oral contraceptives (which have used larger study populations) have not found an increase in heart attack, stroke, or death after the use of oral contraceptives has ceased.

Educational opportunity for young women
Rietzschel notes that the road to poor cardiovascular health is paved in an individual’s early 20s and 30s. In the United States, more than 82 percent of women between the ages of 15 to 44 use oral contraceptives.
           
He believes this gives doctors the perfect opportunity to talk to a large group of women about controlling their cardiovascular risk factors at an age where it could have the most significant impact—before the damage is done.

“If young women are seeking medical attention for long time frames because they want oral contraception, this is a unique opportunity to talk to them about their potential for future cardiovascular disease,” Rietzschel says. He says he would advise those wanting to take the pill to “stop smoking, avoid obesity, be physically active, and get your blood pressure and lipid profile checked.”