DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184475

Lipid profile and cardiovascular risk indices of women on various types of contraceptives in the Ho Municipality of Ghana

Ahmed Tijani Bawah, Michael Asamoah Boateng, Francis A. Osei Kuffour, Mohammed Mustapha Seini, Paul Amoah, Huseini Alidu

Abstract


Background: Hormonal contraceptives (HCs) have been successfully used worldwide to prevent pregnancy by inhibiting ovulation and implantation. These contraceptives have effects on lipid metabolism, body fat and blood pressure which are all risk factors for cardio vascular disease (CVD). Some studies have reported that prolonged use of these hormone-based contraceptives have negative effect on cardiovascular risk indices, however, few of such studies have been done in Ghana, hence this study sought to examine the effect of various forms of contraceptives on cardio vascular risk indices in the Volta Region of Ghana.

Methods: Purposive random sampling was employed in selecting women on various forms of contraceptives and aged-matched controls into the study. Fasting blood sample was collected from each participant after overnight fast for 10-16 hours into plain tubes and the sera used to determine lipid profile. Socio-demographic and BMI variables were also analyzed in this case-control study.

Results: Statistically significant differences were observed for Diastolic Blood Pressure (DBP) (p=0.0153), High Density Lipoprotein levels (HDL) (p=0.001), and the atherogenic index (p=0.0101) between the cases and the controls.

Conclusions: The use of HC significantly affects the DBP, HDL and atherogenic index and these could pose substantial risk for the development of CVD.


Keywords


Blood pressure, Cardiovascular disease, Hormonal contraceptive, Implant, Lipid profile, Oral contraceptive

Full Text:

PDF

References


Frempong BA, Ricks M, Sen S, Sumner AE. Effect of low-dose oral contraceptives on metabolic risk factors in African-American women. J Clinic Endocrinol Metabol. 2008;93(6):2097-103.

Asare GA, Santa S, Ngala RA, Asiedu B, Afriyie D, Amoah AG. Effect of hormonal contraceptives on lipid profile and the risk indices for cardiovascular disease in a Ghanaian community. Int J Women's Health. 2014;6:597.

Health, W. H. O. D. o. R.; Research; Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs, K. F. H. P., Family Planning: A Global Handbook for Providers (2011 Update). 2011.

Kiriwat O, Petyim S. The effects of transdermal contraception on lipid profiles, carbohydrate metabolism and coagulogram in Thai women. Gynecol Endocrinol. 2010;26(5):361-5.

Torkzahrani S, Heidari A, Mostafavi-pour Z, Ahmadi M, Zal F. Amelioration of lipid abnormalities by vitamin therapy in women using oral contraceptives. Clinic Exp Reprod Med. 2014;41(1):15-20.

Crook D, Godsland IF, Wynn V. Oral contraceptives and coronary heart disease: modulation of glucose tolerance and plasma lipid risk factors by progestins. Am J Obstet Gynecol. 1988;158(6):1612-20.

Watanabe RM, Azen CG, Roy SU, Perlman JA, Bergman RN. Defects in carbohydrate metabolism in oral contraceptive users without apparent metabolic risk factors. J Clinic Endocrinol Metabol. 1994;79(5):1277-83.

Enk L, Landgren BM, Lindberg UB, Silfverstolpe G, Crona N. A prospective, one-year study on the effects of two long acting injectable contraceptives (depot-medroxyprogesterone acetate and norethisterone oenanthate) on serum and lipoprotein lipids. Hormone Metabol Res. 1992;24(2):85-9.

LeBlanc ES, Laws A. Benefits and risks of third-generation oral contraceptives. J Gen Internal Med. 1999;14(10):625-32.

Lubianca JN, Faccin CS. Oral contraceptives: a risk factor for uncontrolled blood pressure among hypertensive women. Contracept. 2003;67(1):19-24.

Atthobari J, Gansevoort RT, Visser ST, De Jong PE, De Jong‐van den Berg LT, PREVEND Study Group. The impact of hormonal contraceptives on blood pressure, urinary albumin excretion and glomerular filtration rate. Brit J Clinic Pharmacol. 2007;63(2):224-31.

Lubianca JN, Faccin CS. Oral contraceptives: a risk factor for uncontrolled blood pressure among hypertensive women. Contracept. 2003;67(1):19-24.

Gichuhi JW, Aruasa WK, Oyieke JB, Gichuhi JW. The effect of Depot Medroxyprogesterone acetate contraceptive on body weight and blood pressure in indigenous Kenyan women. Europ Int J Sci Technol. 2014.

Fahmy K, Khairy M, Allam G, Gobran F, Alloush M. Effect of depo-medroxyprogesterone acetate on coagulation factors and serum lipids in Egyptian women. Contracept. 1991;44(4):431-44.

Berenson AB, Rahman M, Wilkinson G. Effect of injectable and oral contraceptives on serum lipids. Obstet Gynecol. 2009;114(4):786-94.

Marshall WJ, Bangert SK. Lipids, lipoproteins and cardiovascular disease. In: Marshall WJ, Bangert SK, eds. Clinical Chemistry. China: Mosby/Elsevier Limited; 2008: 274-275.

Wang Q, Würtz P, Auro K, Morin-Papunen L, Kangas AJ, Soininen P, et al. Effects of hormonal contraception on systemic metabolism: cross-sectional and longitudinal evidence. Int J Epidemiol. 2016;45(5):1445-57.

Amiri M, Tehrani FR, Nahidi F, Kabir A, Azizi F, Carmina E. Effects of oral contraceptives on metabolic profile in women with polycystic ovary syndrome: A meta-analysis comparing products containing cyproterone acetate with third generation progestins. Metabol. 2017;73:22-35.