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    Recent studies confirm the safety of oral contraceptives with respect to stroke.

    CONTRACEPTION REPORT. 1996 Nov; 7(4):4-9.

    Two recent studies provide confirmation of the safety of low-dose oral contraceptives (OCs) with respect to stroke. The first study (Petitti et al.) investigated all strokes that occurred in 1991-94 among women 15-44 years of age who were members of the Kaiser Permanente Medical Care Programs of Northern and Southern California. A total of 408 confirmed strokes occurred among 1.1 million women during 3.6 million women-years of observation. There was no increased risk of ischemic or hemorrhagic stroke among current low-dose OC users. The adjusted odds ratio (OR) for ischemic stroke among current users compared to former users and never users was 1.2 (95% confidence interval (CI), 0.5-2.6). The adjusted OR for hemorrhagic stroke was 1.1 (95% CI, 0.6-2.2). Past users had a significantly decreased ischemic stroke risk compared to never users (OR, 0.5; 95% CI, 0.3-0.98). For subarachnoid hemorrhage, the OR was 1.5 (95% CI, 0.6-3.6) for current users compared to former and never users. The second study (World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception) investigated 3792 cases of stroke, myocardial infarction, and venous thromboembolism and 10,281 hospitalized controls. Current OC use significantly increased the risk of ischemic stroke in both Europe (OR, 3.0; 95% CI, 1.7-5.4.0) and developing countries (OR, 2.9; 95% CI, 2.1-4.0). Current OC use was associated with hemorrhagic stroke in developing countries (OR, 1.8; 95% CI, 1.3-2.3), but not in Europe (OR, 1.4; 95% CI, 0.8-2.3). European users of low-dose OCs showed no excess risk of stroke. Both smoking and hypertension were independent risk factors for stroke.
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