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Hypertension, Oral Contraceptive Agents, and Conjugated Estrogens

[+] Article, Author, and Disclosure Information

Supported in part by grants HE-04745, HE-11031, and FR-00276, National Institutes of Health, Bethesda, Md.

Dr. Crane was supported in part by Career Development Award K3-GM-7627, National Institutes of Health.

▸Requests for reprints should be addressed to M. G. Crane, M.D., Loma Linda University, Loma Linda, Calif. 92354

Loma Linda and Whittier, California

Ann Intern Med. 1971;74(1):13-21. doi:10.7326/0003-4819-74-1-13
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Twenty-two patients developed hypertension on oral contraceptive pills. Mean blood pressure of the group before, during, and after the medication was stopped was 125/76, 183/110, and 130/82 mm Hg, respectively. The average plasma renin activity, the renin substrate, and the aldosterone excretion rate were moderately elevated in the patients who were studied while on the oral contraceptives. In 8 of 10 patients studied 3 to 6 weeks after the medication had been stopped, plasma renin activity failed to have a normal increase in response to sodium restriction and standing. In 3 of 11 patients values were in the hyporesponsive range when they were tested 2 to 7 months later. Five patients were studied who developed hypertension 3 months to 5 years after starting to take a conjugated estrogen. Four became normotensive from 1 to 7 months after they stopped taking the estrogen. The two patients studied had a hyporesponsive plasma renin activity on repeat study in association with an elevated plasma renin substrate while they were taking the estrogen.





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