title: Protrhombotic effects of contraceptives.
abstract: The use of oral contraceptives first became widespread some 40 years ago, and reports of an excess risk of cardiovascular disease among women who used these agents soon followed. Few drugs have been the object of such intensive epidemiological research, the outcome of which has provided clinicians with detailed information about risks not only of specific thrombotic diseases but also important non-contraceptive benefits from the pill. Recently, oral contraceptives have been classified by some according to "generation" (first, second, third, and most recently, fourth generation): first-generation formulations containing lynestrenol or norethindrone, second-generation formulations containing levonorgestrel, third-generation formulations containing desogestrel or gestodene, and oral contraceptives containing an estrogen and other progestagens (cyproterone or norgestimate) or a progestagen alone. The results of several study was that the use of the older high-dose oral contraceptives increased the risk of cardiovascular disease by modifying the Low-density lipoprotein and High-Density lipoprotein cholesterol level, increasing triglyceride serum level, reducing glucose tolerance, raising blood pressure, and promoting clotting mechanisms. In this review we investigate the mechanism of the oral contraceptives and performed a risk assessment of every generation.
authors.affiliation: Cardiology Unit, Department of Medical Pathophysiology, University La Sapienza, Rome, Italy. Giovanni.fazio-aaaa@poste.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fazio
authors.forename: Filippo
authors.initials: F
authors.lastname: Ferrara
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barbaro
authors.forename: Gullotti
authors.initials: G
authors.lastname: Alessandro
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ferrro
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Novo
authors.forename: Salvatore
authors.initials: S
authors.lastname: Novo
mesh_terms: D050197:Atherosclerosis / Q000139:chemically induced; D003276:Contraceptives, Oral / Q000009:adverse effects* / Q000494:pharmacology; D005260:Female; D044882:Glucose Metabolism Disorders / Q000139:chemically induced; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D050356:Lipid Metabolism; D052439:Lipid Metabolism Disorders / Q000139:chemically induced; D008955:Models, Cardiovascular; D009203:Myocardial Infarction / Q000139:chemically induced; D018570:Risk Assessment; D012307:Risk Factors; D020246:Venous Thrombosis / Q000139:chemically induced*
chemical_list: D003276:Contraceptives, Oral