The Use of Oral Contraceptives and the Risks of Developing Prehypertension and Hypertension in Women of Reproductive Age:Findings from a Population-Based Survey in Indonesia

Background: Although the underlying mechanism of the effect of oral contraceptives (OCs) on blood pressure (BP) remains unclear, previous research showed that OCs are associated with an increased risk of elevated BP. This study aims to analyze the association between OCs and the risk of prehypertension and hypertension in women of reproductive age in Indonesia, using longitudinal data from the Indonesian Family Life Survey (IFLS) 5 (2014-2015). Methods: A cross-sectional study was conducted on 10,279 subjects using data from IFLS-5. The study included all women of reproductive age (15-49 years) with complete data on contraceptive use and BP. Sociodemographic factors, physical activity, dietary habits, depressive symptoms, history of tobacco use, and comorbidities were covariates. Multivariate logistic regression analyses were conducted to estimate odds ratios (OR), along with 95% confidence intervals (95% CI) and p-values, comparing women using OCs to those not using contraceptives and those using other modern contraceptive methods. Sub-analyses were conducted for the duration of OC use. Results: The results indicated that OC use was associated with a significantly increased risk of both prehypertension and hypertension. The adjusted odds ratios (aOR) for prehypertension and hypertension were 1.42 (95% CI: 1.16–1.73, p = 0.001) and 1.72 (95% CI: 1.45–2.05, p < 0.001), respectively, compared to non-users. When compared to users of other modern contraceptive methods, the aORs for prehypertension and hypertension were 1.74 (95% CI: 1.21–2.51, p = 0.003) and 1.80 (95% CI: 1.31–2.48, p < 0.001). Sub-analyses showed that the odds of hypertension increased with longer durations of OC use, but no significant association was found for prehypertension. Conclusion: There is a statistically significant moderate increase in the risk of prehypertension and hypertension among women of reproductive age in Indonesia who use OCs, with the risk of hypertension increasing with longer durations of OC use. This finding highlights the need for healthcare providers to carefully assess risks when prescribing contraceptives, particularly for women with cardiovascular risk factors.