What are the risks of oral contraceptives in patients with cardiovascular disease risk factors?
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Women who smoke, have hypertension, hyperlipidemia, or factor V Leiden deficiency and take oral contraception (OC) are at increased risk of myocardial infarction (MI). Third-generation OCs and low-dose OCs are not associated with increased MI risk in women with or without other cardiovascular (CV) risk factors (SOR B, systematic review of cohort studies). OCs are contraindicated in women with preexisting congestive heart failure or CV disease, but may be used in otherwise healthy women with diabetes, hypertension, or hyperlipidemia (SOR C, evidence-based guidelines derived from consensus and expert opinion).
Evidence Based Practice 16(2): 05-06.