Chronic Use of Hormonal Contraceptives and Its Impact on Cardiovascular Risk
Sheila Santa, Bernice Asiedu, Robert A. Ngala, Jonathan Kofi Adjei, Maria Anyorikeya, Brodrick Y. Amoah, George A. Asare
Journal of Advances in Medicine and Medical Research · pp. 1–11 · Published 10 Aug 2016
10.9734/BJMMR/2016/26391Abstract
Aims: The purpose of the study was to observe if hormonal contraceptive use increases CV risk in women from Ghana through increasing CV RF. Study Design: The study was longitudinal and purposive random sampling was done. Place and Duration of Study: A community in the Upper West region of Ghana was selected. The Reproductive Healthcare Clinic which administers contraceptives was used for the study from January 2013 to January 2014. Methodology: Seventy- one (71) cases were recruited (20-40 years). Twenty-three (23) were on an injectable contraceptive (IC), 43 on an oral contraceptive (OC), 5 on a sub-dermal implant contraceptive (IMP) and 4 switched methods from OC to IC or to IMP. After 12 months, a total of 42 remained in the study. Twenty-three (23) remained on IC, 11 on OC and 4 on IMP. Anthropometry [Body mass Index (BMI), Diastolic and Systolic Blood Pressure (DBP,SBP)], Lipid profile [Total Cholesterol (TC), High Density Lipoprotein Cholesterol (HDL), Low Density Lipoprotein (LDL), Triglycerides (TG), Very Low Density Lipoprotein (VLDL), Apolipoprotein A-1(ApoA-1), Apolipoprotein B(Apo B) and cardiovascular risk indices [Castelli index I = TC/HDL; Castelli index II = LDL/HDL; Atherosclerotic risk = (TC-HDL)/HDL; Atherogenic index of plasma = Log TG/HDL] were determined and statistically analyzed. Results: Comparison of the studied groups showed that OC users had significantly increased DBP, BMI, TC, LDL, TG and Apo B (p<0.001, all cases). IC user also had significantly increased BP, BMI, TC, LDL, TG and Apo B (p<0.001), whilst HDL and Apo A-1 reduced significantly (p<0.001). IMP users had significantly increased BP, TC and Apo B (p<0.05). Castelli index I, atherosclerotic risk, atherogenic index of plasma, Apo B/Apo A-1 (a better predictor of coronary risk) increased significantly (p<0.001, respectively), for the OC and IC groups. Conclusion: Chronic use of hormonal contraceptives amongst women has the tendency to cause weight gain, increase BP and dyslipidaemia. IC had the greatest cardiovascular risk.
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