The few women still using the first-generation pill were 1.7 times more likely to have a stroke than women not using any oral birth control. Women taking the third-generation pill had an increased stroke risk 2.2 times that of non-pill users. Those taking the second-generation pill formulations had 2.4 times the risk, says senior author Ale Algra, M.D., associate professor of clinical epidemiology at University Medical Center, Utrecht, Netherlands.
Risk factors for stroke smoking, hypertension, diabetes and high cholesterol appeared to add to the stroke risk in all pill users in the study.
Because there is virtually no difference in the risk of stroke in second- and third- generation pills, the balance of the decision whether to use second- or third- generation oral contraceptives should be determined by the risk of venous thrombosis, blood clots deep in the leg, Algra says.
Last year, Algra and his team linked third-generation OCs with an increased risk of developing blood clots in deep veins of the body (venous thrombosis). In a meta-analysis of previous studies of OCs, the group found a higher risk of venous thrombosis in third generation pills than of second-generation pills. Venous thrombosis usually resolves without complications, but the clots can travel to the lungs, causing a life-threatening pulmonary embolism.
Because of the risk of leg blood clots with third-generation OCs, Algra suggests women use second-generation OCs. Very few women take the first-generation version of the pill.
They seriously should consider using second-generation preparations if they did not use OCs before, or switching from third-generation pills to second-generation pills if they are current users, he stresses.
Contact: Carole Bullock or Bridgette McNeill
American Heart Association