Skip to main content
SpringerLink
Log in

Oral contraceptives in adolescents: a retrospective population-based study on blood pressure and metabolic dysregulation

  • Research
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to explore the relationship between oral contraceptive use and blood pressure values and in a national cohort of women adolescents and to investigate the level of coexistence of the high blood pressure levels, dyslipidemia or insulin resistance.

Methods

This is a retrospective cohort study that evaluated data form 14,299 adolescents aged 14 to 17 years. Crude and race-and age-adjusted analyses were performed using Poisson regression to estimate the prevalence ratios. Data clustering analysis was performed using machine learning approaches supported by an unsupervised neural network of self-organizing maps.

Results

We found that 14.5% (n = 2076) of the women adolescents use oral contraceptives. Moreover, an increased prevalence of high blood pressure, dyslipidemia, and insulin resistance (all P < 0.001) was observed among adolescents who use oral contraceptives as compared to those who do not. Our analysis also showed that 2.3% of adolescents using oral contraceptives had both high blood pressure levels and dyslipidemia, whereas 3.2% had high blood pressure levels combined with insulin resistance (all P < 0.001). The algorithmic investigative approach demonstrated that total cholesterol, LDLc, HDLc, insulin, and HOMA-IR were the most predicted variables to assist classificatory association in the context of oral contraceptive use among women adolescents with high blood pressure.

Conclusions

These findings suggest that oral contraceptives were associated with an increased prevalence of high blood pressure, dyslipidemia, and insulin resistance among women adolescents. Although the indication of this therapy is adequate to avoid unintended pregnancies, their use must be based on rigorous individual evaluation and under constant control of the cardiometabolic risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Not applicable.

References

  1. Borges AL, Fujimori E, Kuschnir MC, Chofakian CB, de Moraes AJ, Azevedo GD et al (2016) ERICA sexual initiation and contraception in Brazilian adolescents. Rev Saude Publica 50:15s. https://doi.org/10.1590/S01518-8787.2016050006686

    Article  PubMed  PubMed Central  Google Scholar 

  2. Todd N, Black A (2020) Contraception for Adolescents. J Clin Res Pediatr Endocrinol 12:28–40. https://doi.org/10.4274/jcrpe.galenos.2019.2019.S0003

    Article  PubMed  PubMed Central  Google Scholar 

  3. Brynhildsen J (2014) Combined hormonal contraceptives: prescribing patterns, compliance, and benefits versus risks. Therapeutic advances in drug safety 5:201–213. https://doi.org/10.1177/2042098614548857

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Williams WV (2017) Hormonal contraception and the development of autoimmunity: a review of the literature. Linacre Q 84:275–295. https://doi.org/10.1080/00243639.2017.1360065

    Article  PubMed  PubMed Central  Google Scholar 

  5. Godsland IF (2005) Oestrogens and insulin secretion. Diabetologia 48:2213–2220. https://doi.org/10.1007/s00125-005-1930-0

    Article  CAS  PubMed  Google Scholar 

  6. Lalude OO (2013) Risk of cardiovascular events with hormonal contraception: insights from the Danish cohort study. Curr Cardiol Rep 15:374. https://doi.org/10.1007/s11886-013-0374-2

    Article  PubMed  Google Scholar 

  7. Liu H, Yao J, Wang W, Zhang D (2017) Association between duration of oral contraceptive use and risk of hypertension: a meta-analysis. J Clin Hypertens (Greenwich) 19:1032–1041. https://doi.org/10.1111/jch.13042

    Article  CAS  PubMed  Google Scholar 

  8. Steenland MW, Zapata LB, Brahmi D, Marchbanks PA, Curtis KM (2013) Appropriate follow up to detect potential adverse events after initiation of select contraceptive methods: a systematic review. Contraception 87:611–624. https://doi.org/10.1016/j.contraception.2012.09.017

    Article  PubMed  Google Scholar 

  9. Gourdy P, Bachelot A, Catteau-Jonard S et al (2012) Hormonal contraception in women at risk of vascular and metabolic disorders: guidelines of the French Society of Endocrinology. Ann Endocrinol (Paris) 73:469–487. https://doi.org/10.1016/j.ando.2012.09.001

    Article  CAS  PubMed  Google Scholar 

  10. Nawrot TS, Den Hond E, Fagard RH, Hoppenbrouwers K, Staessen JA (2003) Blood pressure, serum total cholesterol and contraceptive pill use in 17-year-old girls. Eur J Cardiovasc Prev Rehabil 10:438–442. https://doi.org/10.1097/01.hjr.0000103463.31435.1e

    Article  PubMed  Google Scholar 

  11. Le-Ha C, Beilin LJ, Burrows S, Huang RC, Oddy WH, Hands B, Mori TA (2013) Oral contraceptive use in girls and alcohol consumption in boys are associated with increased blood pressure in late adolescence. Eur J Prev Cardiol 20:947–955. https://doi.org/10.1177/2047487312452966

    Article  PubMed  Google Scholar 

  12. Lewandowski SK, Duttge G, Meyer T (2020) Quality of life and mental health in adolescent users of oral contraceptives. Results from the nationwide, representative German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Qual Life Res 29:2209–2218. https://doi.org/10.1007/s11136-020-02456-y

    Article  PubMed  PubMed Central  Google Scholar 

  13. Kharbanda EO, Parker ED, Sinaiko AR, Daley MF, Margolis KL, Becker M et al (2014) Initiation of oral contraceptives and changes in blood pressure and body mass index in healthy adolescents. J Pediatr 165:1029–1033. https://doi.org/10.1016/j.jpeds.2014.07.048

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bloch KV, Szklo M, Kuschnir MC, Abreu Gde A, Barufaldi LA, Klein CH et al (2015) The Study of Cardiovascular Risk in Adolescents–ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in Brazilian adolescents. BMC Public Health 15:94. https://doi.org/10.1186/s12889-015-1442-x

    Article  PubMed  PubMed Central  Google Scholar 

  15. Souza AA, Almeida DC, Barcelos TS, Bortoletto RC, Munoz R, Waldman H et al (2021) Simple hemogram to support the decision-making of COVID-19 diagnosis using clusters analysis with self-organizing maps neural network. Soft comput 17:1–12. https://doi.org/10.1007/s00500-021-05810-5

    Article  Google Scholar 

  16. Darroch JE, Woog V, Bankole A, Ashford L (2016) Adding it up: costs and benefits of meeting the contraceptive needs of adolescents, New York: Guttmacher Institute, 2016. Guttmacher Institute. https://www.guttmacher.org/report/adding-it-meeting-contraceptive-needs-of-adolescents

  17. 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 Womens Health 13:39. https://doi.org/10.1186/1472-6874-13-39

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Goldhaber SZ, Hennekens CH, Spark RF, Evans DA, Rosner B, Taylor JO et al (1984) Plasma renin substrate, renin activity, and aldosterone levels in a sample of oral contraceptive users from a community survey. Am Heart J 107:119–122. https://doi.org/10.1016/0002-8703(84)90144-3

    Article  CAS  PubMed  Google Scholar 

  19. Chen JT, Kotani K (2012) Oral contraceptive therapy increases oxidative stress in pre-menopausal women. Int J Prev Med 3:893–896. https://doi.org/10.4103/2008-7802.104862

    Article  PubMed  PubMed Central  Google Scholar 

  20. Josse AR, Garcia-Bailo B, Fischer K, El-Sohemy A (2012) Novel effects of hormonal contraceptive use on the plasma proteome. PLoS ONE 7:e45162. https://doi.org/10.1371/journal.pone.0045162

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Naz F, Jyoti S, Akhtar N, Afzal M, Siddique YH (2012) Lipid profile of women using oral contraceptive pills. Pak J Biol Sci 15:947–950. https://doi.org/10.3923/pjbs.2012.947.950

    Article  CAS  PubMed  Google Scholar 

  22. Momeni Z, Dehghani A, Fallahzadeh H, Koohgardi M, Dafei M, Hekmatimoghaddam SH et al (2020) The impacts of pill contraceptive low-dose on plasma levels of nitric oxide, homocysteine, and lipid profiles in the exposed vs. non exposed women: as the risk factor for cardiovascular diseases. Contracept Reprod Med 5:7

    Article  PubMed  PubMed Central  Google Scholar 

  23. Palmisano BT, Zhu L, Stafford JM (2017) Role of Estrogens in the regulation of liver lipid metabolism. Adv Exp Med Biol 1043:227–256. https://doi.org/10.1007/978-3-319-70178-3_12

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Frempong BA, Ricks M, Sen S, Sumner AE (2008) Effect of low-dose oral contraceptives on metabolic risk factors in African-American women. J Clin Endocrinol Metab 93(6):2097–2103. https://doi.org/10.1210/jc.2007-2599

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Deleskog A, Hilding A, Östenson CG (2011) Oral contraceptive use and abnormal glucose regulation in Swedish middle aged women. Diabetes Res Clin Pract 92:288–292. https://doi.org/10.1016/j.diabres.2011.02.014

    Article  CAS  PubMed  Google Scholar 

  26. Cortés ME, Alfaro AA (2014) The effects of hormonal contraceptives on glycemic regulation. Linacre Q 81:209–218. https://doi.org/10.1179/2050854914Y.0000000023

    Article  PubMed  PubMed Central  Google Scholar 

  27. Ginsberg HN, Zhang YL, Hernandez-Ono A (2005) Regulation of plasma triglycerides in insulin resistance and diabetes. Arch Med Res 36:232–240. https://doi.org/10.1016/j.arcmed.2005.01.005

    Article  CAS  PubMed  Google Scholar 

  28. Tricò D, Natali A, Mari A, Ferrannini E, Santoro N, Caprio S (2018) Triglyceride-rich very low-density lipoproteins (VLDL) are independently associated with insulin secretion in a multiethnic cohort of adolescents. Diabetes Obes Metab 20:2905–2910. https://doi.org/10.1111/dom.13467

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This research is not funded by a specific project.

Author information

Authors and Affiliations

  1. Nephrology Division–Department of Medicine, Federal University of São Paulo, São Paulo, Brazil

    Priscila Xavier de Araújo & Danilo Candido de Almeida

  2. Program of Translational Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil

    Priscila Moreira

  3. Laboratory of Applied Computing–LABCOM3, Federal Institute of Education, Science and Technology of São Paulo, São Paulo, Brazil

    Alexandra Aparecida de Souza

  4. Physiology Department, School of Medicine, Federal University of São Paulo, São Paulo, Brazil

    Maria do Carmo Franco

  5. LiTiVasC - Laboratory of Translational Research in Vascular and Molecular Physiology, School of Medicine, Federal University of São Paulo. Rua Botucatu, 862 – 5° floor - , São Paulo, SP, 04023-062, Brazil

    Maria do Carmo Franco

Authors
  1. Priscila Xavier de Araújo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Priscila Moreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Danilo Candido de Almeida
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alexandra Aparecida de Souza
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maria do Carmo Franco
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

P.X.A. and M.C.F. were responsible for article conceptualization. P.X.A. and P.M. made the literature search and prepared the tables. D.C.A. and A.A.S. made the neural network of self-organizing maps. All authors wrote the main manuscript text. All authors were responsible for data curation, drafting, and approval of the manuscript.

Corresponding author

Correspondence to Maria do Carmo Franco.

Ethics declarations

Ethical approval and consent to participate

All participants signed an informed consent form at the time of enrollment. The study was approved by the Research Ethics Committee of the head institution of the national database center (IESC/UFRJ—Process 45/2008) and the accomplishment of the current study was approved by the Research Ethics Committee of the Federal University of São Paulo (Approval Number: 3.007.121).

Consent for publication

All authors read and approve the manuscript and give their consent for submission and publication.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Araújo, P.X., Moreira, P., de Almeida, D.C. et al. Oral contraceptives in adolescents: a retrospective population-based study on blood pressure and metabolic dysregulation. Eur J Clin Pharmacol (2024). https://doi.org/10.1007/s00228-024-03671-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00228-024-03671-z

Keywords

Search

Navigation