Effect of desogestrel-containing oral contraceptives on vascular reactivity and catecholamine levels

Abstract

The modifications induced by new oral contraceptives (OC) on blood pressure, great vessel vascular reactivity by color Doppler, and catecholamine levels were investigated. Young healthy women not taking OC (n = 22; controls) or receiving, for > or = 6 months, OC containing desogestrel with either 30 micrograms (n = 14) or 20 micrograms of EE (n = 8) were enrolled. Blood pressure measured at rest in supine position was similar between controls and OC users. The pulsatility index (PI), an indirect index of resistance to blood flow, of axillary artery was significantly higher (p < 0.05) in 30 micrograms than in 20 micrograms EE OC users or controls. A similar trend, albeit not significant, was observed for the internal carotid artery PI. Norepinephrine (p < 0.01) and dopamine (p < 0.05) but not epinephrine levels, were lower in 30 micrograms EE OC users than in 20 micrograms EE OC users or controls. Thus, both 20 micrograms and 30 micrograms EE OC had no negative effect on blood pressure, but the 30 micrograms EE OC tended to increase great vessel resistance to blood flow, independently of catecholamine levels.

PIP: The effects on blood pressure of oral contraceptives (OCs) containing desogestrel plus either 20 or 30 mcg of ethinyl estradiol were investigated in 22 women who had been using one of these formulations for 6 months or more and 22 matched controls. There were no significant differences between both groups of cases and controls in blood pressure measured at rest in supine position. However, subtle differences were recorded in vascular reactivity, as evaluated by color Doppler ultrasound investigation. Compared to controls and users of OCs containing 20 mcg of ethinyl estradiol, cases taking OCs consisting of 30 mcg of ethinyl estradiol had a significantly higher pulsatility index in the axillary artery, indicating increased vessel resistance to blood flow. A similar, although not significant, trend was found in the internal carotid artery pulsatility index. On the other hand, catecholamine (dopamine and norepinephrine) levels were reduced by both OCs in a dose-dependent manner. Overall, these findings suggest that third-generation OCs, especially those containing 20 mcg of ethinyl estradiol, exert minimal effects on circulatory parameters. It is hypothesized that the cardiovascular effects of catecholamine reduction are antagonized by other mechanisms, among them the stimulus on the renin-angiotensin system.