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Excerpts from: A Matter of the Heart
Adriana Camacho-Church drkoop.com [07/23/01]
Read the study in the Archives of Internal Medicine Low-Dose
Oral Contraceptive Use and the Risk of Myocardial Infarction
A recent study confirmed that women increase the risk of having a first-time
heart attack by 30 times when they smoke 25 cigarettes or more a day and
take a daily, low-dose birth control pill.
Lynn Rosenberg, an epidemiologist at Boston University School of Medicine
in Brookline, Mass., and her colleagues, conducted the research to find out
whether the newer, low-dose birth control pills that contain less than 50
micrograms of estrogen per dose (like those Logan took), are safer than the
oral contraceptives of the past.
Based on her findings, Rosenberg says that in terms of causing
cardiovascular disease, today's low-dose contraceptives "do very little, except
in a heavy smoker."
Light smokers and non-smokers do not seem to be putting themselves at
greater risk of developing heart problems by taking low-dose oral
contraceptives, Rosenberg states in her report.
Published in the April 23rd issue of the Archives of Internal Medicine,
14-year study was conducted in 75 hospitals in the greater-Boston and
Philadelphia area between January of 1985 and March 1999.
Low-dose oral contraceptives were developed after reports suggested that
amount of estrogen in older birth control pills had serious side effects,
including strokes, heart attacks and blood clots.
"High-dose birth control pills did have risks even in the absence of smoking,"
Concerned about all the negative press surrounding oral contraceptives
smoking cigarettes, Logan stopped taking the pill 18 years ago and cut back
from smoking two packs a day to smoking one pack a day.
"I'd rather smoke than take the pill," she says. "It's so hard to quit
According to data collected between 1965 through 1998 by the American
Lung Association, 22.4 million women in the United States smoke. And
about 10 million-take birth control pills annually, reports the National Center
for Health Statistics.
Rita Redberg, a cardiologist at the University of San Francisco, agrees
Rosenberg's findings that today's low-dose birth control pills do little harm to
the heart. The study's findings show there is no reason why women should
not take oral contraceptives, says Redberg. The risk of having a heart attack
from low-dose birth control pills is very low, if any, especially if the woman is
under 35 years of age, doesn't smoke heavily, and doesn't have high blood
pressure or diabetes.
Experts agree that blood clots and heart attacks rise steadily after age
a woman who smokes heavily and is still using oral contraceptives at this
time in her life is greatly increasing her chances of developing a heart attack.
Mary Molan, 50, stopped taking birth control pills at the age of 33 --
after she started. "My doctor told me she wasn't going to prescribe anymore
pills because I was a smoker& she said, take something else."
Molan, also a resident of Wilmington, Del., began smoking cigarettes at
age of 17. By the time she was 23, she was smoking a pack a day and
taking oral contraceptives. In 1997 she stopped smoking cold turkey.
Referring to her study, Rosenberg says, "A woman in her 20s who is a heavy
smoker may not care if her risk of having a heart attack goes up 30 times
because it's so low. But when that woman is 35 and older, her risk increases
because as you age your chances of a heart attack go up. So, it's a different
risk at a different age."
The majority of the women in the study used low-dose combined birth control
pills. Combined pills are made of two synthetic hormones, an estrogen and a
progestogen. In this study, the combined pills contained 30 or 35 micrograms
Data gathered for the study came from interviews with 627 women who had
first time nonfatal heart attack and about 3,000 other women hospitalized for
other reasons. All of them were younger than 45.
Patients interviewed were asked questions about the type of oral
contraceptive they used, smoking habits, menopausal status, cholesterol
levels and family history of heart attacks.
At the end of their report, Rosenberg and her colleagues state that the
current warning inside birth control pill packages, urging users not to smoke
while taking the pill, is still appropriate.
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