MYOCARDIAL INFARCTION AND PAST ORAL CONTRACEPTIVE USE
Project Number5R01HL030225-02
Contact PI/Project LeaderROSENBERG, LYNN
Awardee OrganizationBOSTON UNIVERSITY MEDICAL CAMPUS
Description
Abstract Text
A case control study will be carried out to evaluate whether the long-term
use of oral contraceptives (OCs), after discontinuation, is associated with
an increased incidence of first nonfatal myocardial infarction (MI) among
women above the age of 50 years and younger women.
While it is known that current OC use (use in the preceding month)
increases the risk of MI some three to four-fold, recent evidence raises
the hypothesis that past use that lasted a total of five or more years is
associated with a residual two-fold increase in MI risk among women 40 to
49 years old. Since the incidence of the disease starts to become
appreciable beyond age 49, it is of public health importance to reexamine
this hypothesis in a data base that includes women aged 50 or older, to
determine how long the increased risk, if any, persists, and to determine
whether it varies according to the formulation of the preparation used. An
increase in risk that persists after discontinuation of OC use would have
major public health implications, since millions of women have used or will
use OCs for long periods: in our data, about 5% of women in their 50s,
over 10% of women aged 40-49, and over 15% of women under age 40 have
already used OCs for at least five years. Moreover, many of the OCs used
in the past are still commonly used today.
The study will also enable evaluation of the effects on MI risk of current
OC use, machine-determined levels of carbon monoxide and nicotine in
cigarettes, noncontraceptive estrogens, and other potential risk factors.
The study will be carried out in 78 hospitals located in greater Boston,
southern Connecticut, and Westchester County, a network recently used for a
study of MI in young men. The study will be contined to women 57 years of
age or younger because the rate of past long-term OC use is very low beyond
that age. Cases will be identified by weekly telephone calls to the
coronary care units. Nurse-interviewers will be dispatched to the
hospitals to administer standard interviews to cases convalescing on
medical wards after discharge from the coronary care units, and to controls
identified in the same hospitals. Histories of OC use, including the
timing and duration of use and the name of the preparations, will be
recorded along with information on other drug use, descriptive factors, and
MI risk factors that might be confounding variables or that might modify
the effect of OCs (e.g. cigarette smoking). The data collection will last
three years, and a total of about 900 cases of first infarction and about
3600 controls, approximately frequency matched for age to the cases, will
be studied.
Public Health Relevance Statement
Data not available.
NIH Spending Category
No NIH Spending Category available.
Project Terms
alcoholic beverage consumptionangina pectoriscardiovascular disorder epidemiologycase historycoffeedrug adverse effectestrogensfemalefemale antifertility drughealth surveysheart disorderhormone therapyhuman middle age (35-64)human subjecthypertensionlipid disordermenopausemyocardial infarctionpregnancy toxemia /hypertensiontype A /type B personalityyoung adult human (21-34)
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