scholarly journals Using epidemiological data to guide clinical practice: review of studies on cardiovascular disease and use of combined oral contraceptives

BMJ ◽  
1998 ◽  
Vol 316 (7136) ◽  
pp. 984-987 ◽  
Author(s):  
P. C Hannaford ◽  
V. Owen-Smith
Keyword(s):  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Oral Contraceptives ◽  
Epidemiological Data ◽  
Combined Oral Contraceptives ◽  
Practice Review

scholarly journals Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review

BMJ ◽  
2020 ◽  
pp. m3502 ◽  
Author(s):  
Kelvin Okoth ◽  
Joht Singh Chandan ◽  
Tom Marshall ◽  
Shakila Thangaratinam ◽  
G Neil Thomas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Preterm Birth ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Oral Contraceptives ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Combined Oral Contraceptives

Abstract Objective To consolidate evidence from systematic reviews and meta-analyses investigating the association between reproductive factors in women of reproductive age and their subsequent risk of cardiovascular disease. Design Umbrella review. Data sources Medline, Embase, and Cochrane databases for systematic reviews and meta-analyses from inception until 31 August 2019. Review methods Two independent reviewers undertook screening, data extraction, and quality appraisal. The population was women of reproductive age. Exposures were fertility related factors and adverse pregnancy outcomes. Outcome was cardiovascular diseases in women, including ischaemic heart disease, heart failure, peripheral arterial disease, and stroke. Results 32 reviews were included, evaluating multiple risk factors over an average follow-up period of 7-10 years. All except three reviews were of moderate quality. A narrative evidence synthesis with forest plots and tabular presentations was performed. Associations for composite cardiovascular disease were: twofold for pre-eclampsia, stillbirth, and preterm birth; 1.5-1.9-fold for gestational hypertension, placental abruption, gestational diabetes, and premature ovarian insufficiency; and less than 1.5-fold for early menarche, polycystic ovary syndrome, ever parity, and early menopause. A longer length of breastfeeding was associated with a reduced risk of cardiovascular disease. The associations for ischaemic heart disease were twofold or greater for pre-eclampsia, recurrent pre-eclampsia, gestational diabetes, and preterm birth; 1.5-1.9-fold for current use of combined oral contraceptives (oestrogen and progesterone), recurrent miscarriage, premature ovarian insufficiency, and early menopause; and less than 1.5-fold for miscarriage, polycystic ovary syndrome, and menopausal symptoms. For stroke outcomes, the associations were twofold or more for current use of any oral contraceptive (combined oral contraceptives or progesterone only pill), pre-eclampsia, and recurrent pre-eclampsia; 1.5-1.9-fold for current use of combined oral contraceptives, gestational diabetes, and preterm birth; and less than 1.5-fold for polycystic ovary syndrome. The association for heart failure was fourfold for pre-eclampsia. No association was found between cardiovascular disease outcomes and current use of progesterone only contraceptives, use of non-oral hormonal contraceptive agents, or fertility treatment. Conclusions From menarche to menopause, reproductive factors were associated with cardiovascular disease in women. In this review, presenting absolute numbers on the scale of the problem was not feasible; however, if these associations are causal, they could account for a large proportion of unexplained risk of cardiovascular disease in women, and the risk might be modifiable. Identifying reproductive risk factors at an early stage in the life of women might facilitate the initiation of strategies to modify potential risks. Policy makers should consider incorporating reproductive risk factors as part of the assessment of cardiovascular risk in clinical guidelines. Systematic review registration PROSPERO CRD42019120076.

Oral contraceptives and cardiovascular disease risk in black and white women:

2001 ◽  
Vol 01 (4) ◽  
pp. 175-183
Author(s):  
Kate Wheeler ◽  
Cora E. Lewis ◽  
Dale Williams ◽  
Stephen Sidney ◽  
Catarina I. Kiefe ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Oral Contraceptives ◽  
White Women ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Black And White

Platelet Adhesiveness in Symptomatic Women Taking Oral Contraceptives

1971 ◽  
Vol 26 (03) ◽  
pp. 426-430 ◽  
Author(s):  
T. F Zuck ◽  
J. J Bergin ◽  
Jane M. Raymond ◽  
W. R Dwyre ◽  
D. G Corby
Keyword(s):  
Oral Contraceptives ◽  
Platelet Adhesiveness ◽  
Combined Oral Contraceptives ◽  
Increased Risk ◽  
Normal Women ◽  
Asymptomatic Women

SummaryPlatelet adhesiveness to glass was determined in several groups of women. Increases were found in women developing thrombovascular symptoms while taking combined oral contraceptives, compared to both normal women and asymptomatic users of oral contraceptives. Despite this increase, overlap of the groups did not permit discrimination between symptomatic and asymptomatic women. However, it is possible, that in concert with other coagulation changes, platelet adhesiveness to glass may prove adjunctive in defining women at increased risk of developing thrombovascular symptoms while taking oral contraceptives, and further define the mechanism of the increased risk.

scholarly journals Systematic review of international clinical guidelines for the promotion of physical activity for the primary prevention of cardiovascular diseases

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
N. Aerts ◽  
D. Le Goff ◽  
M. Odorico ◽  
J. Y. Le Reste ◽  
P. Van Bogaert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Clinical Practice ◽  
Cardiovascular Diseases ◽  
Primary Prevention ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Guidelines ◽  
Prevention Programs ◽  
Prevention Of Cardiovascular Disease

Abstract Background Cardiovascular diseases are the world’s leading cause of morbidity and mortality. An active lifestyle is one of the cornerstones in the primary prevention of cardiovascular disease. An initial step in guiding primary prevention programs is to refer to clinical guidelines. We aimed to systematically review clinical practice guidelines on primary prevention of cardiovascular disease and their recommendations regarding physical activity. Methods We systematically searched Trip Medical Database, PubMed and Guidelines International Network from January 2012 up to December 2020 using the following search strings: ‘cardiovascular disease’, ‘prevention’, combined with specific cardiovascular disease risk factors. The identified records were screened for relevance and content. We methodologically assessed the selected guidelines using the AGREE II tool. Recommendations were summarized using a consensus-developed extraction form. Results After screening, 27 clinical practice guidelines were included, all of which were developed in Western countries and showed consistent rigor of development. Guidelines were consistent about the benefit of regular, moderate-intensity, aerobic physical activity. However, recommendations on strategies to achieve and sustain behavior change varied. Multicomponent interventions, comprising education, counseling and self-management support, are recommended to be delivered by various providers in primary health care or community settings. Guidelines advise to embed patient-centered care and behavioral change techniques in prevention programs. Conclusions Current clinical practice guidelines recommend similar PA lifestyle advice and propose various delivery models to be considered in the design of such interventions. Guidelines identify a gap in evidence on the implementation of these recommendations into practice.

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