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Depo-Provera Tied to Increased Heart Disease Risk in Small StudyFrom: Efrain Ramirez (eramirezt@coqui.net)Wed Oct 9 07:02:40 2002
Depo-Provera Tied to Increased Heart Disease Risk in Small Study Sharon Worcester Tallahassee Bureau Chronic use of depot medroxyprogesterone acetate may have an adverse effect on cardiovascular health, a small, nonrandomized study suggests. The widely used, long-acting contraceptive sold as Depo-Provera and given as a 150-mg injection every 12 weeks inhibits ovarian follicle proliferation. This causes anovulation and decreased circulating estrogen, which could lead to reduced arterial function and increased risk of cardiovascular disease, Morten B. Sorenson, Ph.D., of Royal Brompton Hospital, London, and his colleagues reported (Circulation; available at http://circ.ahajournals.org/rapidaccess.shtml; published online Sept. 3, 2002). While the investigators concluded that the “prevailing recommendation to use [Depo-Provera] in women with cardiovascular disease” should be further evaluated, Pharmacia, the drug's maker, is emphasizing its “well-proven” safety profile. “There is no increased risk of cardiovascular disease noted in large-scale clinical or epidemiological trials with Depo-Provera,” Dr. Joel Krasnow, medical director of women's healthcare for Pharmacia, Peapack, N.J., said in a statement issued by the company. The drug has been used safely by millions of women for more than 30 years, but healthcare professionals should always carefully consider the use of any medication, including Depo-Provera, before prescribing, particularly for women with preexisting cardiac risk factors, Dr. Krasnow said. The study included 13 amenorrheic Depo-Provera users and 10 controls with regular menstrual cycles. Cardiovascular magnetic resonance was used to measure changes in the brachial artery area. Hyperemia-induced flow-mediated dilatation, which is an endothelium-dependent indicator of vascular reactivity, was significantly reduced in the Depo-Provera group (to 1.1%), compared with controls (to 8.0%) during menstruation. There were no differences in levels of glyceryl trinitrate, an endothelium-independent indicator of vascular reactivity. S-estradiol levels, however, were found to be significantly lower in the Depo-Provera patients—who had been using the drug and been amenorrheic for at least 1 year—than in controls during menstruation (58 vs. 96 pmol/L). The estradiol levels were significantly correlated to flow-mediated dilatation.
-- "Life is neither the notes nor the silence between the notes, but the music that arises out of sound and silence felt as a living whole. Stop choosing...between chaos and order, and live at the boundary between them, where rest and action move together..." David Whyte
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