title: Effects of a contraceptive containing drospirenone and ethinylestradiol on blood pressure, metabolic profile and neurohumoral axis in hypertensive women at reproductive age.
abstract: The use of combined oral contraceptives is widespread among hypertensive women despite being associated with increased cardiovascular risk. Contraceptives containing drospirenone, which has antimineralocorticoid properties, may have a positive or neutral effect on neurohumoral activation and metabolic homeostasis of hypertensive women at reproductive age.
  
  
  OBJECTIVE
  To evaluate the effect of combined oral contraceptive containing drospirenone+ethinylestradiol on the systemic blood pressure, metabolic variables and neurohumoral axis in hypertensive women in reproductive age.
  
  
  METHODS
  Prospective controlled trial with 56 hypertensive women allocated in two groups: 30 volunteers under oral combined contraceptive use and 26 volunteers using non-hormonal contraceptive methods. Subjects were tested before the introduction of the contraceptive method and 6 months after its use. For data acquisition, we used continuous non-invasive beat-to-beat blood pressure curve recordings and, for the biochemical and hormonal analyses two blood samples were obtained. Student's t test was used to determine differences between groups and moments and p<0.05 was considered statistically significant.
  
  
  RESULTS
  Comparing antropometric and blood pressure measurements, cardiac sympatho-vagal modulation, baroreceptor sensitivity, metabolic and neurohumoral axis variables between baseline and after 6 months, no significant difference was detected in each group or between groups. Except serum triglyceride levels which increased in the group of women using EE+DRSP after 6 months of use.
  
  
  CONCLUSIONS
  A contraceptive containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone causes no significant changes in clinical and autonomic parameters, metabolic variables and neurohumoral axis of hypertensive women.
authors.affiliation: Universidade Nove de Julho (UNINOVE), São Paulo, Brazil.
authors.forename: Tercio Lemos
authors.initials: TL
authors.lastname: de Morais
authors.affiliation: Hypertension Unit, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil; Gynecology Department, University of São Paulo, São Paulo, Brazil.
authors.forename: Cassiana
authors.initials: C
authors.lastname: Giribela
authors.affiliation: Gynecology Department, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcelo Gil
authors.initials: MG
authors.lastname: Nisenbaum
authors.affiliation: Hypertension Unit, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil.
authors.forename: Grazia
authors.initials: G
authors.lastname: Guerra
authors.affiliation: Gynecology Department, University of São Paulo, São Paulo, Brazil.
authors.forename: Nilson
authors.initials: N
authors.lastname: Mello
authors.affiliation: Gynecology Department, University of São Paulo, São Paulo, Brazil.
authors.forename: Edmundo
authors.initials: E
authors.lastname: Baracat
authors.affiliation: Universidade Nove de Julho (UNINOVE), São Paulo, Brazil; Hypertension Unit, Heart Institute (InCor), University of São Paulo, São Paulo, Brazil. Electronic address: fernanda.consolim@uninove.br.
authors.forename: Fernanda M
authors.initials: FM
authors.lastname: Consolim-Colombo
mesh_terms: D000328:Adult; D000450:Aldosterone / Q000097:blood; D000736:Androstenes / Q000494:pharmacology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017704:Baroreflex / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects*; D015992:Body Mass Index; D003277:Contraceptives, Oral, Combined / Q000737:chemistry / Q000494:pharmacology*; D004573:Electrolytes / Q000097:blood; D004997:Ethinyl Estradiol / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D000736:Androstenes; D000959:Antihypertensive Agents; D003277:Contraceptives, Oral, Combined; D004573:Electrolytes; D014280:Triglycerides; D004997:Ethinyl Estradiol; D000450:Aldosterone; C035144:drospirenone
keywords: Cardiovascular risk; Hypertension; Oral contraceptives