The effect of low-dose oral contraceptives on lipids and lipoproteins in two at-risk populations: young female smokers and older premenopausal women.

Young women who smoke and women over age 35 are considered to be at high risk for cardiovascular complications associated with oral contraceptive use. This study evaluated the effects of low-dose oral contraceptives on lipid and lipoprotein concentrations in 45 high-risk patients before, during, and after 6 months of treatment. Neither group showed a significant change from baseline in cholesterol, HDL cholesterol, LDL cholesterol or cholesterol ratios. Triglycerides increased and HDL2a levels decreased significantly in both groups but returned to baseline after treatment was discontinued, with the largest changes in both triglycerides and HDL2a levels occurring at 1 month. The change in triglyceride and HDL2a blood levels were within the laboratories' reference range. The lipid profile of these patients, therefore, was not worsened significantly through 6 months of oral contraceptive use. The young women who smoked did have consistently lowered levels of HDL cholesterol and its HDL2a subfraction when compared to their elder non-smoking cohort.