Combined oral contraceptives: short term blood pressure and lipid profile changes among users in Sagamu, south-western Nigeria

Abstract

Objectives: To determine if there is any association between combined oral contraceptives (COCs) use and blood pressure (BP) change, dyslipidaemia and cardiovascular risks among COCs’ users.

Design: A descriptive cohort study among 162 acceptors of COCs recruited consecutively from 2016-2020.

Setting: Family planning unit of Olabisi Onabanjo University Teaching Hospital, Sagamu, Southwest, Nigeria.

Subjects: Consented women who met the inclusion criteria and took up COCs as a form of family planning within the study period.

Intervention: All the subjects were placed on Levofem DKT brand of combined oral contraceptive pill (levonorgestrel 0.15mg, ethinylestradiol 0.03mg, ferrous fumarate 75mg) at a dose of one tablet daily. Their blood samples were taken for fasting lipid profile (FLP) and their BP measured both at recruitment and at six months of follow-up.

Outcome measures: Change in the FLP and BP within the six months of use of the COC. Data analysis was done using SPSS version 26 by IBM incorporation. Level of significance was set at P<0.05.

Results: The mean age of our participants was 29.53±4.92 years. There was statistically significant association between COCs use and mean change in Total Cholesterol (t =5.263, P=0.001,), Triglyceride (t =24.974, P=0.001), Low density lipoprotein (4.974, P=0.001), high density lipoprotein (t=12.790, P=0.001) as well as the Castelli index 1 and 2 (t= 12.439, P=0.001, t=10.910, P= 0.001). However, there was no relationship between mean change in FLP and BP.

Conclusion: COCs use was associated with dyslipidaemia and indirectly with cardiovascular risks. It showed no significant association with BP change.