复方炔诺酮避孕片与女性高血压风险的关系

Association Between Combined Norethisterone Oral Contraceptives and Risks of Female Hypertension

目的：研究复方炔诺酮避孕片（1号避孕片）与女性高血压风险的关系,以期降低不良反应。方法：采用横断面研究的方法,使用统一的调查问卷、体格检查表对符合入选标准的已婚妇女进行集中调查,采用Logistic回归分析高血压患病因素。结果：①5 596例已婚妇女中患高血压者占12.10%（677例）。②与放置宫内节育器（IUD）妇女比较,曾经服用1号避孕片10~19年和20年以上的妇女患高血压的风险略有升高（调整RR=1.48,95%CI：1.08~2.03;调整RR=1.63,95%CI：1.17~2.27）,正在服用1号避孕片10~19年和≥20年的妇女患高血压的风险也略有升高（调整RR=1.53,95%CI：1.16~2.59;调整RR=1.80,95%CI：1.12~2.90）;③高血压患病的危险因素按标化回归系数绝对值大小排列依次为体质量指数升高、有心脑血管疾病家族史、年龄和使用口服避孕药等。结论：长期使用1号避孕片女性患高血压病风险增加,应对其加强血压水平的随访和医学监护,提高使用口服避孕药的安全性和有效率。

Objective：To assess the association between combined norethisterone oral contraceptives（OC）and the risk of female hypertension so as to decrease the adverse reactions of OC.Methods：In June 2003,a cross-sectional study was conducted to invest the qualified and married women in Shaxi Town of Taicang County by unified questionnaire and physical examination tables.Logistic regression was used to analyze the prevalence factors of hypertension.Results：①The hypertension prevalence among 5 596 women was 12.10%（677 women）.② Compared with those subjects with IUDs,the risk of hypertension prevalence was increased slightly among those who had ever used OC over 20 years（adjusted RR=1.63,95% CI was 1.17～2.27）,the risk was also slightly higher among those who was taking OC over 20 years（adjusted RR=1.80,95%CI was 1.12～2.90）.③According to the standarded coefficient of regression,the risk factors of hypertension were ordered as： increased body mass index,family history of cerebrovascular diseases,age increasing,OC use,etc.Conclusions： There is an increase in the risk of hypertension among long-term users of OC.The results suggested that follow-up of blood pressure and medical care should be strengthened in OC users,so as to improve the safety and efficiency of OC use.