Also, the cardiovascular-related death rate for women aged 35 to 44 has increased since 2000, while decreasing among other groups of women. The obesity epidemic, lack of physical activity, smoking and a rise in the use of oral contraceptives (from 4 percent to 17 percent) among this group of women coincided with the increased mortality rate, the study authors noted.
The new review article found that while newer oral contraceptives pose no increased risk of heart attack for women using them, there does appear to be an increased risk of blood clots. There was no data available on cardiovascular health for the newest generation of hormonal formulations, the study said.
Current guidelines from the American College of Obstetricians and Gynecologists recommend against prescribing birth control pills for women who smoke, are over 35, and those who are obese because the risk for blood clots is increased.
They also state that oral contraceptives with certain doses of estrogen are safer than pregnancy for women aged 35 through menopause.
Women who have high blood pressure or high cholesterol levels need to be monitored and have their conditions controlled if they take oral contraceptives, the study said.
"If patients are hypertensive but are well-controlled, they can use hormonal formulations. Diabetics can use hormonal formulations," Bairey Merz said. "There are several categories of women, including women who smoke, who should not use hormonal contraception and that remains true in this era as well."
Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City, noted that the "world has changed and women are having babies later. Each individual needs to be evaluated for o
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