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The effect of oral Contraceptive pills and the natural menstrual cYCLe on arterial stiffness and hemodynamICs (CYCLIC)

Yu, Alicea; Giannone, Taniaa; Scheffler, Patricka; Doonan, Robert J.a; Egiziano, Giordanoa; Gomez, Yessica-Haydeea; Papaioannou, Theodore G.b; Daskalopoulou, Stella S.a

Journal of Hypertension:
doi: 10.1097/HJH.0000000000000012
ORIGINAL PAPERS: Blood vessels

Background: Over 100 million women currently use oral contraceptive pills (OCPs) worldwide. However, little is known about the effects of OCPs on arterial stiffness and hemodynamics. Furthermore, whether arterial stiffness and hemodynamics vary throughout the natural menstrual cycle remains controversial. Herein, we estimated the effect of the natural menstrual cycle and OCP use on arterial stiffness and hemodynamics.

Methods: Healthy, nonsmoking women, aged 18–30 years, were recruited if they had regular menstrual cycles and never used OCPs (OCP nonuser group), or were using low-dose OCPs for at least 6 months (OCP user group). Using applanation tonometry, three assessments of arterial stiffness and central and peripheral hemodynamics were performed in a randomized order: during the early follicular (days 3–6), late follicular (days 14–16), and luteal (days 22–26) phases. Within group and between group comparisons were performed using general linear models.

Results: Sixty women (21.7 ± 2.8 years) were recruited. Compared with OCP nonusers, OCP users had significantly increased aortic and peripheral SBPs during the active OCP use, but not during the inert tablet phase. No differences in arterial stiffness were noted.

Conclusion: OCP use was associated with significant increases in aortic and peripheral blood pressures, but not with increased arterial stiffness. Given the widespread OCP use, future longitudinal studies are needed to confirm our findings and assess the long-term effect of OCPs on arterial stiffness and hemodynamics.

Author Information

aFaculty of Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada

bBiomedical Engineering Unit, 1st Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

Correspondence to Stella S. Daskalopoulou, MD, MSc, DIC, PhD, FRQS Chercheur-Boursier Clinicien, Associate Professor in Medicine, Division of Internal Medicine, Department of Medicine, Montreal General Hospital, McGill University, McGill University Health Centre, 1650 Cedar Avenue, C2.101.4 Montreal, QC H3G 1A4, Canada. Tel: +1 514 934 1934x42295; fax: +1 514 934 8573; e-mail:

Abbreviations: AIx, augmentation index; AIx75, augmentation index adjusted at a heart rate of 75 bpm; BP, blood pressure; cfPWV, carotid-to-femoral pulse wave velocity; crPWV, carotid-to-radial pulse wave velocity; LUT, luteal phase; MAP, mean arterial pressure; OCP, oral contraceptive pill; PP, pulse pressure; PPampl, pulse pressure amplification; PWA, pulse wave analysis; PWV, pulse wave velocity

Received 15 February, 2013

Revised 23 August, 2013

Accepted 27 August, 2013

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins