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Postmenopausal Former Oral Contraceptives Users May Have Lower Rates of Heart Disease: Presented at NAMS

By Jerry Ingram

MIAMI BEACH, FL -- October 2, 2003 -- Postmenopausal women who are former users of oral contraceptives have lower rates of coronary artery disease (CAD), according to the National Heart, Lung, and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE) Study.

"Prior oral contraceptive use in premenopausal years is associated with a lower prevalence of coronary artery disease and a lower severity score," said Noel Bairey Merz, MD, Medical Director and Women's Guild Endowed Chair, Women's Health Program and Preventive Cardiac Center, Cedars-Sinai Medical Center, Los Angeles, California, United States. "This remains significant despite adjustment for the traditional players in arteriosclerosis."

"This is the first study that has looked at coronary angiograms in a large cohort of women. It's the first look at potential benefit of oral contraceptives later in life," Dr. Merz said.

Dr. Merz and colleagues presented their findings here on September 19^th at the 14^th Annual Meeting of the North American Menopause Society.

Although there were animal studies available indicating the protective characteristics of oral contraceptive use against atherosclerosis, very little effort has been made to study women, oral contraceptive use and coronary artery disease (CAD), Dr. Merz said. Her research team therefore examined 702 postmenopausal women enrolled in the WISE study who were referred for coronary angiography for possible CAD.

Using core laboratory test results to determine a CAD severity score (a measure of atherosclerosis), the investigators determined a quantitative assessment of patients.

Forty-four percent of the women had obstructive CAD, and 39% reported prior oral contraceptive use. Former users of oral contraceptives were younger (57 versus 66 years, P<0.0001), but despite age adjustment had a lower mean CAD severity (11.8 versus 18.7, P<0.002), compared with non-prior users.

Use of oral contraceptive in the past was an independent negative predictor of CAD severity (P=0.04) after adjustment for age, diabetes mellitus, triglyceride level, low-density lipoprotein cholesterol level, smoking, aspirin use, lipid-lowering medication, and socioeconomic variables (model Rē=0.19).

The researchers did not, however, find an apparent relationship between duration of prior oral contraceptive use and severity of CAD.


[Study title: Prior Oral Contraceptive Use and Coronary Artery Disease (CAD): Data from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE) Study. Abstract P51]

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