LOS ANGELES — Hormonal contraception does not appear to affect cardiovascular risk factors in adolescents, Jennifer G. Kapella, M.D., said at the annual meeting of the Society for Adolescent Medicine.
In a study that enrolled 50 adolescent subjects just starting on oral contraception, 22 subjects starting depot medroxyprogesterone acetate, and 53 control subjects, hormonal contraception had no effect on cholesterol levels, and may have had a slightly beneficial effect on carotid artery intima-media thickness over a period of 18 months, said Dr. Kapella of the department of pediatrics at the Metro-Health Medical Center in Cleveland.
There was a slight decrease over the 18 months in intima-media thickness in the control subjects, and a greater decrease in the subjects on either form of hormonal contraception. There was no difference in the decrease between the types of contraception used in the study.
Because all the groups had a decrease in intima-media thickness, and because it is not known how the hormonal milieu of adolescence might change that thickness, Dr. Kapella combined the figures for the three groups of subjects in her presentation.
Overall, the study found a mean 2% drop in thickness at 12 months and a mean 6% drop at 18 months, equal to about 0.02 mm.
Previous studies of intima-media thickness in adolescent girls have found no change over time, while in adolescent boys there appears to be a progression in thickness over time, Dr. Kapella said.
By way of comparison, a 0.02-mm decrease in intima-media thickness is what is seen in statin trials of similar duration, she added.
The fact that a significant decrease in intima-media thickness was seen in the medroxyprogesterone group as well as the oral contraception group was unexpected, and difficult to explain, Dr. Kapella noted.
“We have to consider factors other than contraception as coming into play as the cause of the regression,” she said.