Prospective measurement of blood pressure and heart rate over 24 h in women using combined oral contraceptives with estradiol

ObjectiveCombined oral contraceptives (COCs) containing ethinyl-estradiol are known to increase blood pressure (BP). We evaluated whether COCs containing estradiol (E2) influence 24-h ambulatory BP and heart rate (HR) in normotensive and normal-weight women.Study designTwenty-four-hour BP and HR were measured every 30 min with an ambulatory BP device in 18 normotensive healthy non-smoking women prior to (Days 3–6 of menstrual cycle) and after 6 months of use (Days 20–24 of cycle 6) of a COC containing either a quadriphasic combination of E2 valerate plus dienogest (n=11) or a monophasic association of micronized E2 plus nomegestrol acetate (n=7).ResultsMean age and body mass index of the final sample were 32.50±7.49 years and 22.87±4.08, respectively. E2-based COCs induced no modification of 24-h systolic BP (+ 1.65±8.34 mmHg; p=.41), diastolic BP (+ 0.04±7.36 mmHg; p=.98), mean BP (+ 0.64±6.42 mmHg; p=.68) or HR (− 0.72±5.86 beats/min; p=.61). Differences were not observed even when daytime or nighttime values were separately considered. Though this was not a comparative study, we did not find differences between the effects of the two formulations (24-h mean BP; p=.699).ConclusionsThese data suggest a neutral effect of estradiol-based COCs on independent risk factors for cardiovascular diseases such as BP or HR.ImplicationsBP and HR of normotensive women are not increased by E2-based COCs.