Oral contraceptive pills are associated with a small but significant increase in hypertension risk, highlighting the need for individualized risk-benefit assessments.
Does oral contraceptive pill use increase hypertension risk in reproductive-aged individuals?
This review highlights the small but significant risk of hypertension associated with oral contraceptive pills, emphasizing the need for individualized risk-benefit assessment and appropriate blood pressure monitoring.
Oral contraceptive pills (OCPs) have been used as effective and popular forms of contraception since the middle of the last century. By 2019, over 150 million reproductive-aged individuals were using OCPs to prevent unintended pregnancies worldwide. Safety concerns regarding the effects of OCPs on blood pressure were reported soon after these pills gained approval. Although OCP doses were subsequently reduced, epidemiologic evidence continued to support a smaller, but significant association between OCPs and hypertension. Given the rising prevalence of hypertension, as well as the adverse effects of cumulative exposure to blood pressure elevations on cardiovascular disease risk, understanding the nature of the association between OCPs and hypertension is important for clinicians and patients to assess the risks and benefits of use, and make individualized decisions regarding contraception. Therefore, this review summarizes the current and historical evidence describing the association between OCP use and blood pressure elevations. Specifically, it identifies the pathophysiologic mechanisms linking OCPs to hypertension risk, describes the magnitude of the association between OCPs and blood pressure elevations, and distinguishes the effects of various OCP types on blood pressure. Finally, it describes current recommendations regarding hypertension and OCP use, as well as identifies strategies, such as over-the-counter OCP prescribing, to safely and equitably improve access to oral contraception.
Cameron et al. (Thu,) conducted a review in Hypertension. Oral Contraceptive Pills was evaluated. Oral contraceptive pills are associated with a small but significant increase in hypertension risk, highlighting the need for individualized risk-benefit assessments.