Oral contraceptive containing drospirenone and 24-hour
ambulatory blood pressure. Preliminary data from a prospective study
A. Volpe, C. Alessandrini, S. Ferrari, A. Cagnacci
University of Modena, Department of Obstetrics Gynecology and Pediatrics, Modena, Italy
Objective In normotensive
women, low-dose combined oral contraceptives may lead to a mild rise in blood
pressure. 24-h ambulatory blood pressure monitoring (ABPM) showed that the
increase is particularly evident during night-time, in contrast to nocturnal
circadian BP decline.
Design and methods The study evaluated the influence of
a monophasic formulation containing 30 µg ethinylestradiol (EE) and 3 mg
drospirenone (DRSP) on daily blood pressure. In 10 normotensive women ambulatory
BP was recorded for 41 h at baseline and after 6 months of treatment. Paired t
test was used to compare baseline and post-treatment data.
Results 30 µg EE/3
mg DRSP combination tended to reduce diurnal BP and to increase nocturnal BP. As
the consequence the day-night BP ratio tended to decrease after contraceptive
use, and significantly so for the day-night systolic BP difference (14.07±2.26
mmHg vs. 9.63±1.21 mmHg; P=0.025). Heart rate and body mass index was not
significantly modified by treatment.
Conclusions 30 µg EE/3 mg DRSP
combination do not increase 24-h blood pressure, but tend to blunt the circadian
BP rhythm, by increasing nocturnal and decreasing diurnal blood pressure. The
cardiovascular implication of this attenuation is unclear.