Purpose: Cross-sectional and longitudinal associations of serum lipids and lipoproteins with oral contraceptive (OC) use were examined among white and black women aged 18-27 years in 1985-86 and 1988-1991 in the Bogalusa Heart Study, a study of cardiovascular disease in a Southern community.
Methods: Analyses of covariance.
Results: In 1985-1986, white OC users had significantly (p < 0.05) higher adjusted mean total and low density lipoprotein (LDL) cholesterols, and lower high density lipoprotein (HDL) cholesterol compared with nonusers; black OC users had higher triglycerides and LDL cholesterol, and lower HDL cholesterol. In 1988-1991, white OC users had higher total cholesterol, triglycerides, and LDL cholesterol, while black OC users had higher triglycerides. OC use was unrelated to mean HDL cholesterol levels in 1988-1991; however, a lower percentage of white OC users than nonusers in 1988-1991 had HDL cholesterol levels < 35 mg/dl. Longitudinally, white OC nonusers at baseline who used OCs at follow-up had significant increases from baseline levels in total cholesterol, triglycerides, and very low density lipoprotein (VLDL) and LDL cholesterols; black women showed an increase only in LDL cholesterol. White women who stopped using OCs by follow-up had a decrease in VLDL and LDL cholesterols, and an increase in HDL cholesterol. White OC users at both exams also had a significant increase in HDL cholesterol, whereas women who began using OCs by follow-up did not.
Conclusions: The unfavorable lipid profile associated with OC use was not apparent upon discontinued use. Lack of an adverse effect of OC use on HDL cholesterol at follow-up may be the result of changing formulations, and requires further examination.
PIP: As part of the longitudinal Bogalusa (Louisiana, US) Heart Study, the associations of serum lipids and lipoproteins with oral contraceptive (OC) use were examined in White and Black women 18-27 years of age in analyses conducted in 1985-86 and 1988-91. In the 1985-86 analysis, White OC users had significantly higher adjusted mean total and low density lipoprotein (LDL) cholesterols and lower high density lipoprotein (HDL) cholesterol compared with White non-users. Black OC users had higher triglycerides and LDL cholesterol and lower HDL cholesterol. In 1988-91, White OC users had higher total cholesterol, triglycerides, and LDL cholesterol, while Black OC users had higher triglycerides. Although OC use was unrelated to mean HDL cholesterol levels in 1988-91, a lower percentage of White OC users than non-users in 1988-91 had HDL cholesterol levels under 35 mg/dl. Longitudinally, White OC non-users at baseline who used OCs at follow up had significant increases from baseline levels in total cholesterol, triglycerides, and very low density lipoprotein (VLDL) and LDL cholesterols; Black women showed an increase only in LDL cholesterol. White women who stopped using OCs by follow up had a decrease in VLDL and LDL cholesterols and an increase in HDL cholesterol. White OC users at both examinations also had a significant increase in HDL cholesterol, while women who began OC use by follow up did not. These findings confirm the adverse effect of OC use on serum lipids and lipoproteins in young women, but indicate these trends are reversed upon discontinuation of OC use. The change in the association of OC use with HDL cholesterol over time may reflect recent decreases in the estrogen component of the pill and changes in progestin types.