Arterial Stiffness and Hemodynamics in Young Women: The Effects of Oral Contraceptive Intake and Physical Habits.

Carina Enea,Pernelle Laffetas,Nathalie Delpech,Aurélien Pichon

doi:10.3390/ijerph18073393

Carina Enea, Pernelle Laffetas + Show 2 more

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https://doi.org/10.3390/ijerph18073393

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Abstract

Oral contraceptive (OC) intake seems to be associated with increased central hemodynamics and arterial stiffness. Conversely, physical activity (PA) is known to induce benefits on vascular structure and function, suggesting that the negative effects of the OC pill could be counterbalanced by regular PA. The aim of this cross-sectional study was to determine (1) whether OC intake in young women is associated with higher values of hemodynamic parameters and arterial stiffness and (2) whether these negative effects could be counterbalanced by regular physical activity. Forty-nine young healthy women (21.9 years ± 2.1) were recruited and divided into 4 groups, depending on their hormonal status (OC users: OC+ or non-OC users: OC−) and their physical habits (active/inactive). Assessments of central hemodynamics (central blood pressure, Aix75) and pulse wave velocity (PWV) were performed using applanation tonometry. cBP was higher in OC+ vs. OC−, while PWV was similar between these two groups. No interaction between physical activity and hormonal status was observed for any of these variables. Nevertheless, PWV was lower in young active women compared with age-matched inactive women, suggesting that the positive effect of regular physical exercise on the cardiovascular system is already visible in the first years of women’s adulthood, whatever the hormonal status.

Highlights

Oral contraceptive (OC) pills are the most widely used form of contraception in Europe and North America (17.8% of women) and are taken by over 150 million women worldwide [1]
The type of progestin is important since it has been shown that OC containing levonorgestrel is associated with more pronounced changes in FMD than an OC containing chlormadinone, a progestin derived from progesterone [50]. To conclude this part of the discussion, our results suggest that the higher central blood pressure observed in OC users is not related to an enhancement of aortic arterial stiffness (PWV) in this population
Our study confirms that women using OC have heightened central blood pressure (BP) when compared to non-users, it is not known whether this difference is clinically meaningful and if it induces an increase of the long-term CVD risk in this population

Summary

Introduction

Oral contraceptive (OC) pills are the most widely used form of contraception in Europe and North America (17.8% of women) and are taken by over 150 million women worldwide [1]. In part because OC are effective and safe for contraception, and due to the fact that premenopausal women have lower cardiovascular risk than age-matched men, there has been relatively little specific study evaluating the effect of OC use on specific markers of cardiovascular health. It is well-known that endogenous sex hormones ( 17ß-estradiol) provide cardiovascular protection in young women [2], the exogenous hormones contained in OC could be associated with rare but serious cardiovascular events, mainly due to thrombolic complications [3]. Several pathophysiological mechanisms, such as oxidative stress [7], endothelial dysfunction, activation of the Renin-Angiotensin-Aldosterone System (RAAS) [8] and arterial stiffness [9]

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