Oral contraceptive use is associated with increased cardiovascular reactivity in nonsmokers

Women who smoke and take oral contraceptives (OCs) have significantly incre ased risk of cardiovascular disease, but the exact mechanisms for the incre ased risk are not known. Cardiovascular reactivity to psychological stress may be one mechanism for the enhanced risk, but the small number of studies examining whether OC users who smoke have greater reactivity have produced mixed results. ne purpose of this study was to examine the effect of chron ic cigarette smoking, acute nicotine administration, and OC use on cardiova scular and lipid reactivity. Sixty healthy women, half of whom had been usi ng OCs for at least the previous 6 months, participated in the study. Appro ximately two thirds were smokers and were randomized to be tested after eit her a 12-hr nicotine deprivation or administration of nicotine gum. One thi rd were nonsmokers. Heart rate, blood pressure, and lipid measures were tak en at rest, during a videotaped speech task and during recovery from the ta sk. Results indicated that, among OC nonusers, there was no effect of smoki ng status or nicotine administration on cardiovascular reactivity. However, among OC users, nonsmokers had significantly greater heart rate and diasto lic blood pressure reactivity to stress. These data show that acute nicotin e administration, in the form of nicotine gum, has no effect on cardiovascu lar or lipid stress reactivity in women. However OC use among nonsmoking wo men is associated with greater cardiovascular reactivity to stress.