Meta-Analysis the Effect of Oral Combination Contraceptive on Hypertension and Stroke
DOI:
https://doi.org/10.26911/thejmch.2022.07.05.03Abstract
Background: Combined oral contraceptives are a form of contraception that are considered safe and effective for some women, but this does not rule out the possibility that combined oral contraceptives contribute to adverse health effects. Several epidemiological studies have shown that oral contraceptives have adverse effects on women's health. The use of contraceptive pills containing the hormones estrogen and progesterone can cause an increase in blood pressure and also stroke if used continuously. The purpose of this study was to estimate the magnitude of the risk of using combined oral contraceptives on the incidence of hypertension and stroke with a meta-analysis study.
Subjects and Method: This was a systematic review and meta-analysis using PRISMA flowchart diagram guidelines. The article search process was carried out between 2007-2022 using 3 databases, including Google Scholar, PubMed, and Science Direct. The keywords used in the database search were “oral contraceptive” OR “contraceptive pills” OR “combined oral contraceptive” AND “hypertension” OR “blood pressure” AND “stroke” AND “women of reproductive age”. The inclusion criteria for full text articles using case control observational methods, articles using English, and articles using multivariate analysis with adjusted Odds Ratio results. Articles that have met the requirements are analyzed using the RevMan 5.3 application.
Results: A total of 14 articles with case-control study designs originating from China, Ethiopia, the United States, Italy, and the Netherlands were carried out in a meta-analysis in this study. Meta-analysis of 7 articles showed that the effect of using combined oral contraceptives was to increase the incidence of hypertension 1.44 times compared to those who did not use combined oral contraceptives (aOR= 1.44; 95% CI= 1.12 to 1.84; p= 0.004). Meanwhile, 7 articles showed that the effect of using combined oral contraceptives was to increase the incidence of stroke by 2.08 times compared to those who did not use combined oral contraceptives (aOR= 2.08; 95% CI= 1.48 to 2.92; p < 0.001).
Conclusion: Combined oral contraceptives increase the risk of hypertension and stroke.
Keywords: combined oral contraceptives, hypertension, stroke, meta-analysis
Correspondence:Ulul Azmi Zuhaira. Master’s Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: ululazmizuhaira@gmail.com. Mobile: +6282245012258.
References
Baziad A (2014). Kontrasepsi hormonal edisi kedua (Hormonal contraceptives second edition). Jakarta: PT Bina Pustaka Sarwono Prawirohardjo.
BKKBN (2015). Rencana strategis badan kependudukan dan keluarga berencana nasional (National population and family planning agency strategic plan). 1–43.
CEBMa (2014). Critical Appraisal for Case Control. Amsterdam.
Chen C, Li Y, Chen F, Pan H, Shen H, Sun Z, Wu Y, et al. (2010). Estrogen receptor beta genetic variants and combined oral contraceptive use as relates to the risk of hypertension in Chinese women. Arc Med Res. 41(8): 599–605. DOI: 10.1016/j.arcmed.2010.10.011.
Gatiningsih, Sutrisno E. (2017). Kependudukan dan ketenagakerjaan (Population and employment). In Modul Mata Kuliah.
Johnson W, Onuma O, Owolabi M, Sachdev, S (2016). Stroke: a global response is needed. Bull World Health Organ, 94(9): 634A-635A. DOI: 10.2471/BLT.16.181636.
Kemenkes RI (2014). Pusdatin Hipertensi (Hypertension Center). Infodatin, Hipertensi, 1–7. DOI: 109019817400200403.
Kemenkes RI (2021). Profil kesehatan Indonesia tahun 2020. Jakarta: Kemenkes RI.
Maitre SC (2013). History of oral contraceptive drugs and their use worldwide. Best Pract Res: Clin Endocrinol Metab, 27(1): 3–12. DOI: 10.1016/j.beem.2012.11.004.
Pangaribuan L, Lolong DB (2015). Hubungan penggunaan kontrasepsi pil dengan kejadian hipertensi pada wanita usia 15-49 tahun di Indonesia tahun 2013 (The relationship between the use of oral contraceptives and the incidence of hypertension in women aged 15-49 years in Indonesia in 2013). Media Penelitian dan Pengembangan Kesehatan. 25(2): 1–8. DOI: 10.22435/mpk.v25i2.4233.8996
Park H, Kim K (2013). Associations between oral contraceptive use and risks of hypertension and prehypertension in a cross-sectional study of korean women. BMC Women’s Health, 13(39): 1–7.
Pezzini A, Grassi M, Lacoviello L, Zotto ED, Archetti S, Giossi A, Padovani A (2007). Inherited thrombophilia and stratification of ischaemic stroke risk among users of oral contraceptives. J Neurol, Neurosurg and Psychiatry, 78(3): 271–276. DOI: 10.1136/jnnp.2006.101675.
Rotermann M, Dunn S, Black A (2015). Oral contraceptive use among women aged 15 to 49: results from the canadian health measures survey. Health Reports, 26(10): 21–28. https://pubmed.ncbi.nlm.nih.gov/26488824/.
Wang C, Li Y, Bai J, Qian W, Zhou J, Sun Z, Ba L, et al. (2012) Increased risk of stroke in oral contraceptive users carried replicated genetic variants: a population-based case-control study in China. Hum Genet, 131(8): 1337–1344. DOI: 10.1007/s0043901211617.
Wang C, Li Y, Bai J, Qian W, Zhou J, Sun Z, Ba L, et al. (2011). General and central obesity, combined oral contraceptive use and hypertension in chinese women. Am J Hypertens, 24(12): 1324–1330. DOI: https://doi.org/10.1038/ajh.2011.157.
Wei W, Li Y, Chen F, Chen C, Sun T, Sun Z, Wu Y, et al. (2011). Dyslipidaemia, combined oral contraceptives use and their interaction on the risk of hyper-tension in Chinese women. J Hum Hypertens, 25(6): 364–371. DOI: 10.1038/jhh.2010.67.
WHO (2018). Noncommunicable Disease: Country Profile 2018.
Xu Z, Li Y, Huang X, Shen W, Bai J, Shen C, Zhao Y (2017). ESR2 genetic variants and combined oral contraceptive use associated with the risk of stroke. Arch Med Res, 48(2): 203–211. DOI: 10.1016/j.arcmed.2017.03.015.