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NEW YORK (Reuters Health) - In young, healthy, normal-weight women, use of newer "third-generation" oral contraceptive pills may raise levels of an inflammatory protein linked to heart disease known as C-reactive protein, or CRP -- potentially placing these women at higher risk for blood clots and heart disease, researchers report.
Both second- and third-generation birth control pills contain a form of estrogen called ethinylestradiol coupled with another hormone called a progestin. The difference between the two types of pills is the type of progestin they contain. The newer contraceptives contain either desogestrel or gestodene, and the older ones contain levonorgestrel or norgestrel.
Third-generation OC pills containing desogestrel or gestodene were introduced to reduce the adverse effects of oral contraceptives, especially cardiovascular disease, Dr. Sabina Cauci from the University of Udine, Italy, and colleagues explain in the journal Obstetrics and Gynecology.
However, evidence suggests that these preparations do not reduce, but may even increase, the risk of blood clots compared with previous generations, they point out.
To investigate further, Cauci's team measured levels of CRP, homocysteine -- another protein linked to heart disease -- and lipids in 77 users of third-generation oral contraceptives and 200 women of similar age who did not use oral contraceptives.
Levels of CRP "posing a high risk of cardiovascular disease" were present in significantly more contraceptive users than nonusers (27.3 percent versus 8.5 percent), they report.
Moreover, levels of CRP posing an intermediate risk of heart disease were present in 32.5 percent of contraceptive users versus 11.0 percent of nonusers.
Use of third-generation contraceptives did not alter homocysteine levels, according to the investigators, and seemed to have a beneficial impact on the cholesterol profile in young women, although it caused harmful triglycerides to go up.
"Our study showed that many young, healthy, normal-weight oral contraceptive users have elevated concentrations of high-sensitivity CRP and thus they are potentially at higher cardiovascular disease risk than nonusers," Cauci's team writes. They add, "Because this low-grade inflammatory condition is asymptomatic, it is not normally recognized and/or investigated."
SOURCE: Obstetrics and Gynecology, April 2008.
