Oral contraceptive pill hypertension.

Abstract

Although the prevalence of pill-induced or -enhanced hypertension is uncertain data have demonstrated the development of new hypertension or the acceleration of preesisting high blood pressure following administration of estrogen-containing oral contraceptives (OCs). The report incidence of hypertension ranges from 0 to 18% and 0 to 7% in patients without antecedent hypertension. Preeclampsia has a similar rate. The renin-angiotensin system is affected by estrogen which stimulates the hepatic synthesis of renin substrate. Estrogen also depresses urinary solium excretion in normal humans and directly contributes to sodium retention. Estrogen-induced changes in cardiovascular status are attributable to the hypertensive effect of the pill. Increased sympathetic activity has been postulated as a mechanism responsible for essential and pill-related hypertension. Possible risk factors increasing hypertensive susceptibility include genetic character istics preexisting and occult renal disease age and weight and possibl e antececent eclampsia. Careful examinations and complete histories pri or to and close observations during OC therapy are advised. Those who become hypertensive or have hypertensive symptoms should be with drawn from therapy. Good results have been reported in those women taking OCs from the middle range.