Low‐dose oral contraceptives and 24‐hour ambulatory blood pressure

Cardoso, Filomena; Polónia, Jorge; Santos, Alejandro; Silva-Carvalho, J; Ferreira-de-Almeida, J

doi:10.1016/s0020-7292(97)00239-7

Cited by 65 publications

(35 citation statements)

References 16 publications

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“…In a prospective Nurses Health Study, self-reported systolic and diastolic BPs among current users were higher than never users by only 0.7/0.4 mm Hg [79]. However, four recent studies using 24-hour ambulatory BP monitoring indicated a much higher BP in normotensive OC users than in nonusers throughout the menstrual cycle of about 6-8/4-6 mm Hg [80][81][82][83]. Interestingly, these studies suggest an even greater influence of OC on nighttime than daytime BP [80,82], which may explain the difficulty in detecting the BPraising effect of OC with clinic (daytime) BP alone.…”

Section: Oral Contraceptives and Hypertensionmentioning

confidence: 96%

“…However, four recent studies using 24-hour ambulatory BP monitoring indicated a much higher BP in normotensive OC users than in nonusers throughout the menstrual cycle of about 6-8/4-6 mm Hg [80][81][82][83]. Interestingly, these studies suggest an even greater influence of OC on nighttime than daytime BP [80,82], which may explain the difficulty in detecting the BPraising effect of OC with clinic (daytime) BP alone. In these studies, the difference in BP between OC users and nonusers was only detected with ambulatory BP monitoring [80,83].…”

Section: Oral Contraceptives and Hypertensionmentioning

confidence: 98%

“…Interestingly, these studies suggest an even greater influence of OC on nighttime than daytime BP [80,82], which may explain the difficulty in detecting the BPraising effect of OC with clinic (daytime) BP alone. In these studies, the difference in BP between OC users and nonusers was only detected with ambulatory BP monitoring [80,83]. A similar finding has also been reported in hypertensive women [84], as OC users with identical office BP to that of nonusers with essential hypertension had strikingly (9 mm Hg) higher ambulatory systolic BP than did nonusers.…”

Section: Oral Contraceptives and Hypertensionmentioning

confidence: 99%

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Estrogen and hypertension

Ashraf

Vongpatanasin²

2006

Current Science Inc

140

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Menopause is accompanied by a dramatic rise in the prevalence of hypertension in women, suggesting a protective role of endogenous estradiol on blood pressure (BP). Both animal experimental and human clinical investigations suggest that estrogen engages several mechanisms that protect against hypertension, such as activation of the vasodilator pathway mediated by nitric oxide and prostacyclin and inhibition of the vasoconstrictor pathway mediated by the sympathetic nervous system and angiotensin. However, emerging evidence from recent clinical trials indicates a small increase, rather than decrease, in systolic BP with oral estrogen administration in postmenopausal women, without any detectable effect on diastolic BP. Mechanisms underlying this selective rise in systolic BP in postmenopausal women and oral contraceptive-induced hypertension in premenopausal women remain unknown, but the rise may be related to supraphysiologic concentration of estrogen in the liver. To date, transdermal delivery of estrogen, which avoids the first-pass hepatic metabolism of estradiol, appears to have a small BP-lowering effect in postmenopausal women and may be a safer alternative in hypertensive women.

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Section: Oral Contraceptives and Hypertensionmentioning

confidence: 96%

Section: Oral Contraceptives and Hypertensionmentioning

confidence: 98%

Section: Oral Contraceptives and Hypertensionmentioning

confidence: 99%

See 1 more Smart Citation

Estrogen and hypertension

Ashraf

Vongpatanasin²

2006

Current Science Inc

140

View full text Add to dashboard Cite

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“…On the other hand, the exclusion of females may help to avoid circadian variation of BP mainly related to oral contraceptives, hormone replacement, and menopause. 38,39 Second, our sample size is relatively small to detect differences in some parameters such as frequency of nondipping or the magnitude of the BP decrease in patients with and without masked hypertension after CPAP treatment. The significant fall in all BP variables derived from 24-hour ABPM and not in the office diastolic BP may be related to the small sample size.…”

Section: Drager Et Al Osa Prehypertension and Masked Hypertensionmentioning

confidence: 99%

The Effects of Continuous Positive Airway Pressure on Prehypertension and Masked Hypertension in Men With Severe Obstructive Sleep Apnea

et al. 2011

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Abstract-Obstructive sleep apnea and hypertension are common conditions that frequently coexist. Continuous positive airway pressure (CPAP) reduces blood pressure in patients with obstructive sleep apnea and sustained hypertension. However, the impact of CPAP on patients with obstructive sleep apnea and prehypertension and masked hypertension, conditions associated with increased cardiovascular risk, is unknown. Thirty-six male patients (age, 43Ϯ7 years; body mass index, 28.8Ϯ3.0 kg/m 2 ) with untreated severe obstructive sleep apnea (apnea-hypopnea index, 56Ϯ22 events/hr on polysomnography) with diagnostic criteria for prehypertension and/or masked hypertension, based on office and 24-hour ambulatory blood pressure monitoring, respectively, were studied. The patients randomized to no treatment (control; nϭ18) or CPAP (nϭ18) for 3 months had similar frequency of prehypertension and masked hypertension at study entry. There were no significant changes in blood pressure in patients randomized to the control group. In contrast, patients randomized to CPAP presented significant reduction in office systolic (from 126Ϯ5 to 121Ϯ7 mm Hg; Pϭ0.001) and a trend for diastolic blood pressure (from 75Ϯ7 to 73Ϯ8 mm Hg; Pϭ0.08) as well as a significant decrease in daytime and nighttime systolic and diastolic blood pressure (PϽ0.05 for each comparison). There was a significant reduction in the frequency of prehypertension (from 94% to 55%; Pϭ0.02) and masked hypertension (from 39% to 5%; Pϭ0.04) only in the CPAP group. In conclusion, effective CPAP therapy promotes significant reduction in the frequency of prehypertension and masked hypertension by promoting significant blood pressure reductions in patients with severe obstructive sleep apnea.

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“…46,52 Além disso, a preocupação nas mulheres hipertensas se relaciona às possíveis complicaç ões, como AVE e IAM. 46,[53][54][55] Estudos mostram que o uso de contraceptivos orais aumenta o risco de eventos vasculares em mulheres hipertensas ou naquelas que não tiveram sua pressão arterial medida antes do início do uso.…”

Section: Hipertensão Arterial (Has)unclassified