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Letters |1 November 1998

Epidemiology of Oral Contraceptives and Cardiovascular Disease

Lisa Chasan-Taber, ScD; Meir J. Stampfer, MD

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Author, Article, and Disclosure Information
  • University of Massachusetts; Amherst, MA 01003 Brigham and Women's Hospital; Boston, MA 02115
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Vandenbroucke and colleagues state that we present the “recency of market introduction” as a potential source of bias in evaluating the risk for venous thromboembolism associated with oral contraceptives containing the new progestogens. They misconstrued our argument as stating that the risk for thrombosis is “higher in the early periods” of use and then declines over time. We instead suggest that clinicians prescribe newly introduced drugs to a population different from the population receiving more established drugs. Thus, the relative risk for venous thromboembolism in users of new drugs may be elevated because the population to whom new drugs are prescribed has a higher baseline risk. The excess risk observed by Bloemenkamp and colleagues [1] in younger women (a population in which most new users will be found) further supports this argument.
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Chasan-Taber L, Stampfer MJ. Epidemiology of Oral Contraceptives and Cardiovascular Disease. Ann Intern Med. ;129:747. doi: 10.7326/0003-4819-129-9-199811010-00019

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Published: Ann Intern Med. 1998;129(9):747.

DOI: 10.7326/0003-4819-129-9-199811010-00019

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