Oral contraceptive use not linked to CVD, all-cause death in women

Women who use oral contraceptives do not have an excess risk of cardiovascular disease (CVD) events and all-cause death, with the contraceptives potentially conferring benefits to those who have used them for longer, according to a study.

This study involved 161,017 women (mean age 53.5 years, 93.2 percent White, 49.1 percent had university or college degrees) who were free of CVD at baseline. All of them completed questionnaires and interviews and reported their oral contraceptive use. Cox proportional hazard models were used to estimate the association of oral contraceptive use and the risk of CVD events and mortality.

Of the women, 131,131 (81.4 percent) used oral contraceptives at baseline. Compared with nonusers, oral contraceptive users were younger, had lower body mass index (BMI), were more likely to be current smokers, had a higher rate of being current drinkers, and had a lower history of hypertension and diabetes.

Oral contraceptive use was associated with lower risks of all-cause death (adjusted hazard ratio [aHR], 0.92, 95 percent confidence interval [CI], 0.86–0.99), incident CVD events (aHR, 0.91, 95 percent CI, 0.87–0.96), coronary heart disease (aHR, 0.88, 95 percent CI, 0.81–0.95), heart failure (aHR, 0.87, 95 percent CI, 0.76–0.99), and atrial fibrillation (aHR, 0.92, 95 percent CI, 0.84–0.99).

There were no associations seen for CVD death, myocardial infarction, or stroke.

Finally, the association between oral contraceptive use and CVD events was stronger among participants with longer durations of use (p<0.001 for trend).