Key result
Oral contraceptive use in hypertensive women is linked to increased albuminuria and plasma renin activity.
Observational (n=114)
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Reveals increased albuminuria without a prominent renin-angiotensin role in oral contraceptive-associated hypertension, indicating alternative pathways maintain elevated blood pressure.
-The determinants of the increase in arterial blood pressure associated with the use of estrogen-progestogen oral contraceptives (OC) remain poorly known. The purpose of this study was to assess the renal characteristics and the role of the renin-angiotensin system in women with OC-associated hypertension. Urinary clearances of technetium-labeled diethylene triaminopentaacetic acid (glomerular filtration rate) and 131I-ortho iodohippurate (effective renal plasma flow) were estimated before and after acute administration of captopril in 38 women who became hypertensive while taking OC, 38 non-OC users with essential hypertension matched for age, body mass index, and level of blood pressure, and 38 normotensive women (19 with and 19 without OC). Plasma renin activity was higher in OC hypertensives when compared with those with essential hypertension, but captopril-induced changes in blood pressure and renal hemodynamics and function were similar in both groups. In addition, 24-hours urinary albumin excretion was increased in OC users when compared with nonusers with similar arterial blood pressure. In 13 hypertensive women followed up for 6 months after OC withdrawal, a decrease in plasma renin activity, blood pressure, and glomerular filtration rate but no significant change in urinary albumin excretion and captopril-induced changes in blood pressure and renal hemodynamics were observed. These results indicate that the use of OC is associated with an increased albuminuria and no evidence of a prominent role for the renin-angiotensin system in the maintenance of high blood pressure and renal hemodynamics when compared with non-OC users with essential hypertension.
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Ribstein et al. (1999) conducted an observational in Oral contraceptive-associated hypertension (n=114). Estrogen-progestogen oral contraceptives and acute captopril administration vs. Non-oral contraceptive users with essential hypertension and normotensive women was evaluated on Renal hemodynamics (GFR and effective renal plasma flow), 24-hour urinary albumin excretion, plasma renin activity, and blood pressure response to acute captopril. Oral contraceptive use in hypertensive women (n=38) was associated with increased 24-hour albuminuria and plasma renin activity, but similar captopril-induced changes vs essential hypertension.
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