低剂量口服避孕药与妇女高血压关系的研究

A Study on the Correlation of Low - dose Oral Contraceptive with Hypertension.

对连续服用国产低剂量复方炔诺酮(1号片)和低剂量复方18-甲基炔诺酮(复方18甲)5～25年及同期使用宫内节育器(IUD)的健康妇女457例进行动脉压测定,对血压均值、高血压患病的危险性及其影响因素进行分析。结果表明:与同期IUD对照比较,长期服用低剂量复方避孕片(COC)有升高血压的作用,且1号片大于复方18甲(P<0.01)。分层分析表明连续使用低剂量口服避孕药(OC)15年以上增加患高血压的危险性,1号片组的相对危险度(RR)为3.36(95％CI1.62,6.97 P<0.01),复方18甲组的RR值为2.27(95％CI 1.05,4.88 P<0.05)。Logistic回归分析提示:从事农业生产劳动、有心脑疾患家族史、体质指数、使用COC及长期摄入COC的总剂量为高血压有显著意义的影响因素。研究结果还表明该人群中确诊高血压者已知血压高的比例较低,仅15％～30％。建议在服OC妇女中定期监测血压,在血压达正常高限的妇女中开展高血压一级预防,降低高血压患病危险性。

This paper analyzed the mean of blood pressure and risk of hypertension caused by oral contraceptives (OCs).457 women participated including 169 of combined Norethisterone(NET) (containing EE 35μg and Norethisterone 625μg for 5-25 years), 158 of 18 -metayi - Norethisterone (containing EE 30μg and Norgestrl 300μg for 5-25 years), and 133 of IUD (for the corresponding period).The result showed that low - dose combined OCs have the potential to cause adverse effects on blood pressure. The mean of systolic pressure(SBP) and di-astolic pressure(DBP) in NET users was higher than that in Norgestrl users(P<0.05). The stratified analysis showed that the risk of hypertension was markedly increased in users taking the low - dose combined OCs for more than 15 years, the relative risk(RR) for hypertension in NET users was 3.36, (95% confidence interval of the difference was 1.62 to 6.97 P<0.01), RR in Norgestrl users was 2.27, (95% confidence interval of the difference was 1.05 to 4.88 P< 0.05).The results of logistic regression analysis suggested that farm work, total dose of OCs intake, family histories of heart disease or stroke and body mass index were singnificonty correlated with the risk of hypertension. The results also showed that the informed hypertension rate was low, only 15% -30% in this population of hypertension examined. Our findings suggest that blood pressure should be monitored regularly and once, hypertension fallnded alternative contraceptive methods should be advised in long term taking low -dose combined OCs.