A combined oral contraceptive containing 30 mcg ethinyl estradiol and 3.0 mg drospirenone does not impair endothelium-dependent vasodilation

Meendering, Jessica R.; Torgrimson, Britta N.; Miller, Nicole P.; Kaplan, Paul

doi:10.1016/j.contraception.2010.03.009

Cited by 31 publications

(28 citation statements)

References 55 publications

(74 reference statements)

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“…In the current study, use of drospirenone-containing OCP was independently associated with increased FMD of the brachial artery when compared to use of estrane/gonane-containing OCPs. This observation is consistent with previous reports that drospirenone increases expression and activity of endothelial nitric oxide synthase in cultured human vein umbilical cells and that drospirenone does not antagonize estrogen-dependent effects on FMD in the brachial artery in healthy pre-menopausal women [23,24]. A favorable impact of drospirenone on endothelium-mediated vasodilation is also consistent with previous work demonstrating salutary effects of mineralocorticoid receptor blockade with spironolactone and eplerenone on nitric oxide-mediated dilation in experimental models and patients with cardiovascular disease [25,26].…”

Section: Discussionsupporting

confidence: 93%

Oral contraceptive use, iron stores and vascular endothelial function in healthy women

Friedman

Cremer²,

Jelani

et al. 2011

Contraception

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Background Increased iron stores are associated with greater cardiovascular risk in post-menopausal women. Oral contraceptive pill (OCP) use decreases the volume of menstrual blood loss and increases iron stores, but the link between OCP use, iron stores, and cardiovascular risk in pre-menopausal women has not been characterized. Study Design We conducted a cross-sectional study of 23 healthy OCP users to determine the association between type and duration of OCP exposure, iron stores, and vascular endothelial function [flow-mediated dilation (FMD) in the brachial artery]. Results Median duration of OCP use was 45 months. FMD in the brachial artery was significantly associated with progestin type used (estranes/gonanes vs. drospirenone) and duration of OCP use (both p<0.05) but not iron stores. In multivariate analysis, progestin type was the only independent predictor of FMD. Conclusions Use of OCP containing drospirenone was independently associated with greater FMD in the brachial artery, and thus a potentially more favorable cardiovascular risk profile, when compared with use of OCP containing estranes/gonanes.

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Section: Discussionsupporting

confidence: 93%

Oral contraceptive use, iron stores and vascular endothelial function in healthy women

Friedman

Cremer²,

Jelani

et al. 2011

Contraception

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“…levonorgestrel, desogestrel (Torgrimson et al, 2007), but not by DRP, a progestin with antiandrogenic and antimineralocorticoid activity (Meendering et al, 2010). Consistent with these findings, it has been demonstrated that endothelial function was less in women using either a levonorgestrel combined OCP or medroxyprogesterone acetate (MPA) (a highly androgenic progestin) compared to nonusers (Meendering et al, 2010).…”

Section: Oral Contraceptives May Further Exacerbate the Metabolic Prosupporting

confidence: 67%

The Polycystic Ovary Syndrome Status - A Risk Factor for Future Cardiovascular Disease

Ilie¹,

Ilie²,

Mocan³

et al. 2012

Recent Advances in Cardiovascular Risk Factors

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“…This is an important issue deserving of study, as there is a growing body of evidence that exogenous and combined-hormone oral contraceptives can impact vascular function in different and complex ways from endogenous forms. 35–37 This presents many important questions, including what role does long-term oral contraceptive use have on MSNA-vascular control? What is the role of β-adrenergic vasodilation in pre- and post-menopausal women exposed to oral contraceptives throughout long periods of their lifespan?…”

Section: Discussionmentioning

confidence: 99%

Ovarian Cycle and Sympathoexcitation in Premenopausal Women

Carter

Joyner

2013

Hypertension

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The influence of the ovarian cycle on muscle sympathetic nerve activity (MSNA) remains controversial. Some studies report an increase of resting MSNA during the midluteal (ML) phase of the ovarian cycle compared to the early follicular phase (EF), while others do not. These inconsistent findings may be due, in part, to the variable surges in estradiol and/or progesterone. We tested the hypothesis that the degree of sympathoexcitation during the ML phase (ΔMSNA) is associated with changes in estradiol (ΔE2) and progesterone (ΔP). Multiple regression analysis of data from previous studies with complete recordings of mean arterial pressure (MAP), MSNA, E2, and P during both EF and ML phases were available from 30 eumenorrheic women (age, 28±1 yr; BMI, 23±0 kg/m2). ML phase increased E2 (37±2 to 117±9 pg/ml; p<.001), P (1±0 to 11±1 ng/ml; p<.001), and MSNA (12±1 to 15±1 bursts/min; p=.02), but did not alter MAP (83±2 to 83±2 mmHg; p=.91). ΔMSNA was correlated to ΔE2 (r=−.50, p=.003) and ΔE2/ΔP (r=−.52, p=.002), but not ΔP (r=.21, p=.13). There was no association between ΔMAP and ΔE2 (r=−.13, p=.49), ΔP (r=−.04, p=.83), or ΔE2/ΔP (r<.01, p=.98). In conclusion, sympathoexcitation during the ML phase of the ovarian cycle appears to be dependent, in part, upon the degree of sex steroid surges. This dynamic interaction between E2, P, and MSNA likely explains previously reported inconsistencies in the field; it remains possible that other sex steroids, such as testosterone, might explain further variance.

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A combined oral contraceptive containing 30 mcg ethinyl estradiol and 3.0 mg drospirenone does not impair endothelium-dependent vasodilation

Cited by 31 publications

References 55 publications

Oral contraceptive use, iron stores and vascular endothelial function in healthy women

Oral contraceptive use, iron stores and vascular endothelial function in healthy women

The Polycystic Ovary Syndrome Status - A Risk Factor for Future Cardiovascular Disease

Ovarian Cycle and Sympathoexcitation in Premenopausal Women

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