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December 1, 1978

Myocardial Infarction and Other Vascular Diseases in Young Women: Role of Estrogens and Other Factors

Author Affiliations

From the Boston Collaborative Drug Surveillance Program, Boston University Medical Center (Dr Jick, Ms Dinan, and Ms Herman), and Department of Epidemiology, Harvard University School of Public Health (Dr Rothman).

JAMA. 1978;240(23):2548-2552. doi:10.1001/jama.1978.03290230040022

We studied 83 women younger than 46 years with acute myocardial infarction (MI) and 154 controls. There was a strong positive association between MI and the following: (1) age, (2) both oral contraceptive and noncontraceptive estrogen use, (3) cigarette smoking, and (4) the presence of predisposing medical conditions, eg, past MI, hypertension, and diabetes. ABO blood type and family history of arterial disease were also positively associated with MI. Whereas the risks for idiopathic stroke and venous thromboembolism have also been shown to be increased among oral contraceptive users, there is comparatively little correlation between these two illnesses and age or smoking in young women. The present study, taken together with previously published work, provides reasonable estimates of the vascular risks associated with oral contraceptive use.

(JAMA 240:2548-2552, 1978)