The third - and latest - generation of birth control pills appears to carry
a smaller risk of heart attack than its predecessor, a Dutch study found.
But the second, slightly older version of the contraceptive, still widely
used, more than doubles the risk of heart problems, the researchers said.
The real danger to the women turned out to be smoking... Among all women
taking some form of the pill, the risk of a heart attack was 13 times
greater among those who smoked compared to nonsmokers. About 100 million
women who can bear children in developed countries use oral
contraceptives... The new study, led by Dr. Bea C. Tanis of the Leiden
University Medical Center, found that the risk of a heart attack was 2.8
times greater for women using first-generation oral contraceptives compared
to women who had not been on the pill. The risk dropped to 2.4 times for
women using the second generation medicines, the study of 1,173 women found.
But women who took the current, third-generation pills had essentially the
same risk as other women, according to findings published Thursday in The
New England Journal of Medicine...

"The link between smoking and heart attack use was independent of any use of
birth controls or other risk factors for heart disease," said Dr. Meir
Stampfer of Harvard School of Public Health. "This is by far the number one
risk factor for heart disease in women." That's a troubling finding, because
smoking in women shot up in the last decade: 22-million American women now
light up, including 30 percent of high school seniors. Doctors agreed women
should not necessarily switch to the newer pill. For one thing, the number
of women taking the third-generation pills in the new study was so low that
the researchers cautioned that they still cannot say that contraceptives
pose no risk to the heart. Additionally, an earlier study came to an
opposite conclusion, finding a greater risk of heart attack in the third
generation than in the second. Other studies have shown a greater risk of
lung-threatening blood clots with third-generation pills, especially in
young women and those who are just starting the pill, cautioned the Dutch
study's lead investigator, Dr. Frits Rosendaal of Leiden University Medical
Center...

News links:
Heart risks higher in older birth control pills: study: But smoking the real
danger - MSNBC
http://www.msnbc.com/news/675258.asp
New Oral Contraceptives Slightly Safer for Heart - Yahoo!/HealthScout
http://dailynews.yahoo.com/h/hsn/20011219/hl/new_oral_contraceptives_slightl
y_safer_for_heart_1.html
Study link:
Oral Contraceptives and the Risk of Myocardial Infarction - NEJM
http://content.nejm.org/cgi/content/short/345/25/1787
Related Editorial: [Subscribers only]
Oral Contraceptives and Myocardial Infarction - The Search for the Smoking
Gun - NEJM
http://content.nejm.org/cgi/content/short/345/25/1841