Abstract P1101: Hormonal Contraceptive Use, Arterial Stiffness and Renin Angiotensin System Activity in Women

Abstract

Background: Oral contraceptive use is associated with increased CV risk. Whether non-oral hormonal contraceptive use poses a similar risk is unclear. Objectives: To evaluate the association between oral and non-oral hormonal and arterial stiffness and renin-angiotensin system (RAS) activity in premenopausal women. Methods: Healthy premenopausal women using non-oral hormonal contraception (NOHC), oral hormonal contraception (OC) (minimum duration of 3 months) and controls were studied in a fasting, high-salt state. Aortic augmentation index (AIx) and pulse wave velocity (PWV) were measured at baseline and in response to Angiotensin II (AngII) challenge, a validated marker of arterial RAS activity. Results from the 3 groups were compared using ANOVA and presented as mean and standard error. Results: Fifty-six women (6 OC, 8 NOHC, 42 controls) were studied. Women were similar in age (OC 29±7yvs NOHC 28±4yvs controls 32±2y, p=0.52)and BMI (OC 26.7±1vsNOHC 22.3±2vs controls25.3±4, p=0.12). No differences were observed amongst the groups with regards to baseline arterial stiffness measures (AIx: OC 4.08±1%; NOHC -2.75±2%; controls 9.01±3%; p =0.10; PWV: OC 6.94±3 m/s; NOHC 6.4±2 m/s; controls 8.04±5m/s; p=0.49). In response to AngII challenge, NOHC users had a greater change in AIx compared to OC after adjustment for age and blood pressure (NOHC 17.06±3%; controls 9.76±1%; p=0.048). No significant changes in PWV were observed among NOHC or OC and controls. Conclusions: Arterial RAS is lower in non-oral hormonal contraceptive users, suggesting this may be a safer contraception option in women at high risk of CVD.