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    Old 04-03-2004, 08:06 AM   #1
    lilleth
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    Oral Contraceptives and high blood pressure

    I am 45 and have been treated for hbp for about several years. HBP runs in my family, and my dad died of a heart attack at age 64. In the past I took oral contraceptives without any problems, but stopped about 8 years ago. I have asked my gyn and GP to prescribe oral contraceptives to control some perimenopausal symptoms. My GP sent me to a cariologist to for a stress echo, which revealed that I have labile hypertension but a very strong heart and no valve damage. I have been taking cardizem 120 and 1/2 of a 37.5 mg maxide pill for about 4 years. I tried Toprol, Cozaar, and diuretics and perhaps one other medicine before the cardizem, but they made me feel bad and did not control some tachycardia I was having. Recently my gp gave me permission to stop taking the Cardizem because I was feeling so bad, and the readings I am getting at home have started going DOWn rather than up. It is running about 110/70 to 120/80 for the past week, with it being a little higher at 8 pm than at 8 am. So, this is a long story I realize and I am omitting many details, but my question is, how much of a risk do you think it would be to take oral contraceptives? The gyn prescribed ortho tri cyclen lo, but said that he prefers not to give oral contraceptives containing estrogen to women in their 40s with hbp, even if it is borderline and under control. He prefers prescribing Micronor, which is a progestin only mini pill. The gp is comfortable with it if bp is under control but warns that the risk of blood clots still goes up. So, I have another appt with gp next week to review readings since going off Cardizem and would like input from anyone here who has experienced using birth control pills while on blood pressure meds. Thanks.

     
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    Old 04-03-2004, 09:11 AM   #2
    zuzu8
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    Re: Oral Contraceptives and high blood pressure

    Lilleth-

    I think your gyn is one smart cookie.

    As you may know, last summer, a vast government study confirmed potential health risks of estrogen replacement therapy for menopausal women. The results were so alarming that they halted the study early. It was a huge shock to millions of women (and their doctors!) who had been on HRT, some for years, for relief of menopausal symptoms. Women and physicians alike also had been lead to believe that estrogen was heart-protective. Turns out it INCREASES risk of heart attack and stroke.

    Adding estrogen back into your life simply gives you one more cardiovascular risk factor to worry about.
    I wouldn't take a chance.

    zuzu xx

     
    Old 04-03-2004, 09:47 AM   #3
    lilleth
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    Re: Oral Contraceptives and high blood pressure

    Well, yes I have done a significant amount of reading and know about the halted studies (there was another recently stopped as well), but I have also read that those studies all focused on Prempro, the estrogen made from mare urine. Some gyns seem to feel that enough research hasn't been done on other forms of HRT to warrant stopping them all based on the Prempro research. Elizabeth Vliet, who is an expert on hormones and has written several books, feels that lack of estrogen as women approach menopause really does play a role in rising BP levels. So I am pretty confused and not certain whether to believe all the hoopla about HRT. I do know that I felt better when I took bcp's in earlier years. Thanks so much for your input.

     
    Old 04-03-2004, 09:51 AM   #4
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    Re: Oral Contraceptives and high blood pressure

    One more note: I failed to mention that the CARDIOLOGIST gave me the go ahead to take estrogen containing birth control pills.

     
    Old 04-03-2004, 10:29 AM   #5
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    Re: Oral Contraceptives and high blood pressure

    Yeah, I'm with you kid! It's all pretty confusing, with so much conflicting opinion.

    You're right, the first halted study was with Prempro (estrogen plus progestin). Then they continued the study with estrogen (Premarin) only.
    Then THAT study was recently stopped because researchers thought they had enough data to determine that estrogen replacement did not reduce the risk for heart disease among post-menopausal women -- which was the clinical question the study sought to answer -- but it did increase the risk for stroke.

    The project director for the Women's Health Initiative, Dr. Jacques Rossouw, said that the increased stroke risk showed up about two years after women started the estrogen therapy and remained constant.

    Jeesh...I, along with most of my girlfriends, were among the original HRT public-at-large guinea pigs...For ten years we happily taking our pills and thinking that we were protecting our hearts and reducing risk of stroke.

    Anyway, after discussion with my gyn, who feels like yours does, I made the choice to get off... I weaned off slowly...had been on Activella..non- mare's urine estrogen (plus progestin). But weaning or no, lo and behold, PLUNGED back into hot flashes for the first time in ten years. It's about 1 1/2 years now and I'm still flashing. But it's bearable.

    Of course now I have to be extra extra vigilent about calcium intake and exercise, to protect my bones, which is the one good thing everyone seems to be in agreement about regarding estrogen.

    It's a tough call, and an individual and very personal one.

    Hypertension/stroke killed all of the women on my mom's side of the family early.
    I'm doing everything I can I guess, not to be one of them.
    Obviously, if the flashes were truly incapacitating I'd be thinking twice!

    zuzu xxx

     
    Old 04-03-2004, 05:52 PM   #6
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    Re: Oral Contraceptives and high blood pressure

    Hi,

    I tried bp twice, once in my early twenties and mid-thirties and both times my blood pressure skyrocketed and went down within days of stopping them. I wasn't on any blood pressure meds at the time. The only birth control pill that I tolerated without raising my blood pressure was a new pill called Yasmin. It has a bit of a diuretic in it. I was on it for 6 months before my pressure went up, and in this case I don't think it was related to the pill. I just stopped it in January and was taking it for perimenopause too. I was not on it with bp meds. I now use a Vivelle patch instead of the pill. I think there are less risks associated with it because it is in a patch form and is not taken by mouth and doesn't have to pass through the liver. By the way, how did you tolerate Cardizem? Did it have side effects? I took one dose and couldn't sleep all night feeling my heart pound in my head...these side effects are unpredictable. Good luck.

     
    Old 04-04-2004, 04:59 AM   #7
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    Re: Oral Contraceptives and high blood pressure

    jahee -
    Is the patch as effective in birth control as the pill? It is something that I, too, asked my GP about when she put me on hbp meds in Feb and she said that since I was under 35 (age 29) to stay on the pill. I've been on it solid for 11 years, and she said that since I originally went on it for regulation, that going off would bring back the erratic months. But... I have read the risks associated with hbp and can't help but wonder. I had not known what you said about the patch not going through the liver. I think that is another question to add to my list when I go to the cardiologist at the end of the month. Thanks for mentioning the patch!
    ~ Mandy

     
    Old 04-04-2004, 07:48 AM   #8
    lilleth
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    Re: Oral Contraceptives and high blood pressure

    Is there anyone else on these boards who might weigh in on this? I'm interested in experiences various people have had with hormones. I'm not menopausal yet, so no hot flashes, but I have other perimenopausal symptoms that affect me pretty seriously. Also, there is still that caveat that these studies were all using the horse urine HRT, and there are other forms of hormones available. I'm really interested too in people's experiences with birth control pills and whether that has raised their bp. Thanks again.

     
    Old 04-04-2004, 07:51 AM   #9
    lilleth
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    Re: Oral Contraceptives and high blood pressure

    I did not tolerate Cardizem very well. I was tired all the time and don't think I realized until recently that it was exhausting me. When the doctor raised my dosage from 120 to 180 mg, I was totally wiped out and had headache and stomachache. I only took that for 3 days, and now we are experimenting with no cardizem. I swear that my bp is LOWER now, and I do fell a lot better. I still take Maxide.

     
    Old 04-07-2004, 10:18 AM   #10
    jahee
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    Re: Oral Contraceptives and high blood pressure

    I take the patch for perimenopause symptoms, not birth control. However, I think there is a new birth control patch.

     
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