C-reactive protein and homocysteine as predictors of cardiovascular risk associated to hormonal contraceptives use

L. Dima, M. Moga, I. Șamotă, L. acea, D. Feștilă, A. Pascu

Abstract: Hormonal contraceptives (HC) are currently the most commonly prescribed method to prevent pregnancy. Although the composition of oral contraceptives has markedly changed over time, venous thromboembolism is the main determinant of the risk-benefit profile in HC use. High concentrations of homocysteine and C reactive protein (CRP) are linked as independent predictor factors of cardiovascular events risk and might be sensitive to hormonal changes in HC users. The aim of present study was to synthesise the available data on the relationship between CRP and homocysteine levels in HC use. We found considerable amount of evidence to support the association between increased CRP level and HC use, while the relationship with the homocysteine level is not well established. However, given the evidence linking inflammation and homocysteine to cardiovascular risk, homocysteine-folate to hormonal changes, as well as HC use to thromboembolic risk, elucidating these aspects by long term prospective studies for various types of combined HC is needed. Filling the gap of knowledge on the subject might allow the development of preventive strategies for thromboembolic risk. Demonstrating possible additional benefits of adding folic acid to HC on reducing the cardiovascular risk demands further investigation.
DOI:10.18643/gieu.2015.199

Keywords: hormonal contraceptives, C-reactive protein, homocysteine, folic acid, venous thromboembolism, cardiovascular risk factors.