What is the relationship between the combined oral contraceptive pill and heart attacks?

The combined oral contraceptive pill has slight adverse effects on the lipids (“fat" chemicals) in the blood and these changes are known risk factors for heart disease. Heart attacks before the menopause are rare. Studies of patients on the early high dose preparations of the combined oral contraceptive pill found a five-fold increase in the incidence of heart attacks. Further studies demonstrated that there are usually confounding (additional) factors contributing to the attacks. In particular, smoking increases the risks. With the more modern low dose pills the risks are probably lower. The latest evidence suggests that there is no increased risk of heart attacks for oral contraceptive users.

The current recommended advice is that smokers should discontinue the combined oral contraceptive pill at the age of 35years. The best advice is that smokers should stop smoking.


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