Tyrolean study

Young “pill” users have high cholesterol

The effects and possible side effects of using oral contraceptives in adults have been well researched. Scientists from Innsbruck have now investigated important cardiovascular parameters in connection with the use of the pill in adolescents. One key finding: the young women have significantly higher cholesterol levels than non-users of oral contraceptives.

Anna Staudt from the Innsbruck University Children's Hospital (Pediatrics II) and her co-authors investigated the potential influence of hormonal contraception on lipid metabolism - in many ways decisive for atherosclerosis and therefore cardiovascular disease in the long term - as part of the large "Early Vascular Ageing-Tyrol Study" (EVA-Tyrol; North, East and South Tyrol). "Oral contraceptives are among the most widely used contraceptive measures for adults and adolescents. Nevertheless, the effects of oral contraceptives on blood lipid levels in adolescents have not yet been well studied," the scientists have now written in the "Journal of Adolescent Health".

The effect is already known in adults
The gaps in knowledge sound astonishing. After all, according to the scientists: "In Austria, 52 percent of female adolescents aged between 16 and 20 report using oral contraceptives as their method of contraception." In adult women, the use of the pill has been linked to increased triglyceride concentrations in the blood. The findings on the influence of hormonal contraception on the "bad" LDL cholesterol were partly contradictory.

As part of the recently published study, blood lipid levels (cholesterol, triglycerides) and the use of the pill were determined or recorded twice at an average interval of 22 months in 14 to 19-year-old female participants in the EVA study between 2015 and 2018. A total of 828 young women with a median age of 17 were involved. 317 (38 percent) stated that they were using oral contraceptives (OCs). "OC users had slightly higher systolic and diastolic blood pressure values (...) and smoked more often than non-users of oral contraceptives," the researchers wrote.

There were significant differences in the blood lipid values: the young women who used the pill had significantly higher values (179.6 milligrams of total cholesterol per deciliter of blood on average) than test subjects who did not use hormonal contraceptives (162.4 milligrams per deciliter of blood). There were also clear differences in the "bad" LDL cholesterol levels of 106.4 milligrams per deciliter ("pill" users) and 94.6 milligrams per deciliter (without hormonal contraception). In contrast, the "good" HDL blood lipid values were roughly the same.

"Take into account during consultation"
In any case, these findings should be taken into account when advising and educating young women who are considering using the pill. The Innsbruck scientists: "We have shown an association (independent of other factors; note) between the use of hormonal contraception and blood lipid levels and their change over time in a large group of healthy female adolescents. These changes are particularly relevant for adolescents with other risk factors for lipid metabolism disorders or other cardiovascular risk factors."

Cardiovascular diseases based on vascular calcification etc. develop over the course of years and are usually based on a combination of several risk factors such as high blood lipid levels, high blood pressure, lack of physical activity, obesity and diabetes. According to scientific studies, between eight and 17 percent of young people in Europe, the USA and Africa have high blood lipid and/or blood pressure levels.