| Author/Editor | Dobert-Ribeiro, Myriam; Medina, Ernesto; Artigas, Jorg; He, Shen; Hui, Zhong Yu; De-Wei, Zhang; Weijin, Zhao; Rajas, Oscar; Vessey, Martin; Kožuh-Novak, Mateja | |
| Title | Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: results of an international, multicentre, case-control study | |
| Type | članek | |
| Source | Lancet | |
| Vol. and No. | Letnik 348, št. 9026 | |
| Publication year | 1996 | |
| Volume | str. 505-10 | |
| Language | eng | |
| Abstract | BACKGROUND: The risk of haemorrhagic stroke associated with use of oral contraceptives (OCs) is less well-established than that for ischaemic stroke. We assessed the risk of haemorrhagic stroke associated with current use of modern OCs as now used throughout the world. METHODS: In this WHO collaborative, case-control study, we assessed the association between risk of haemorrhagic stroke and use of combined OCs in 1068 cases, aged 20-44 years, and 2910 age-matched controls. We also assessed risks for all strokes combined (haemorrhagic, ischaemic, and unclassified) based on 2198 cases and 6086 controls. FINDINGS: Overall, current use of combined OCs was associated with slightly increased risk of haemorrhagic stroke; the increase was significant in the developing countries (odds ratio 1.76 Š95 percent CI 1.34-2.30Ć) but not in Europe (1.38 Š0.84-2.25Ć). Use of OCs in women younger than 35 years did not affect risk of haemorrhagic stroke in either group of countries, whereas in women aged older than 35 years, odds ratios were greater than 2. Women who were current users of OCs and had a history of hypertension (detected before current episode of OC use, but not during pregnancy) had a substantially increased risk (ten-fold to 15-fold) of haemorrhagic stroke compared with women who did not use OCs and had no history of hypertension. Odds ratios among current OC users who were also current cigarette smokers were greater than 3. In both groups of countries, past use of OCs, dose of oestrogen, and dose and type of progestagen had no effect on risk, and risks were similar for subarachnoid and intracerebral haemorrhage. The odds ratios for any type of stroke associated with current use of low-dose ( less th. 50 micrograms oestrogen) and higher-dose OCs were 1.41 (0.90-2.20) and 2.71 (1.70-4.32), respectively, in Europe and 1.86 (1.49-2.33) and 1.92 (1.48-2.50) in the developing countries.(trunc.) | |
| Descriptors | CEREBRAL HEMORRHAGE CEREBROVASCULAR DISORDERS CONTRACEPTIVES, ORAL, COMBINED ADULT CASE-CONTROL STUDIES HYPERTENSION INCIDENCE ODDS RATIO RISK FACTORS SUBARACHNOID HEMORRHAGE WORLD HEALTH CEREBRAL HEMORRHAGE CEREBROVASCULAR DISORDERS DEVELOPING COUNTRIES EUROPE |