Cardiovascular risk and lipid disorders among women using hormonal contraceptives in Gondar Town Northwest Ethiopia

Abstract

Hormonal contraceptives (HCs), containing synthetic estrogen and/or progesterone, are widely used to prevent unintended pregnancies. However, concerns remain regarding their effects on lipid metabolism and cardiovascular risk. To assess serum lipid profile, cardiovascular risk using Castelli Risk Index, and associated factors among hormonal contraceptive users in Gondar Town, Northwest Ethiopia. A comparative cross-sectional study was conducted from March to May 2022, involving 264 women (132 HC users and 132 non-users). Sociodemographic, clinical, and behavioral data were collected using structured questionnaires. Fasting blood samples were analyzed for serum lipid parameters. Castelli Risk Index (CRI) I, II, and III were calculated to estimate coronary heart disease (CHD) risk. Mean lipid levels were compared using independent t-tests, and logistic regression identified factors associated with dyslipidemia. HC users had significantly higher mean levels of total cholesterol (163.0 ± 35.1 vs. 149.4 ± 28.2 mg/dL), triglycerides (91.6 ± 30.1 vs. 82.2 ± 29.9 mg/dL), and LDL-C (102.2 ± 29.3 vs. 77.5 ± 24.6 mg/dL), and significantly lower HDL-C (43.3 ± 11.2 vs. 50.0 ± 7.9 mg/dL) compared to non-users (p < 0.001). The Castelli Risk Index values (CRI-I, II, and III) were also elevated among HC users, with increases of 30.78%, 59.61%, and 34.93%, respectively, indicating a higher risk of coronary plaque formation and CHD. Hormonal Contraceptive use, having higher waist-to-hip ratio, and urban residence were independently associated with dyslipidemia among study participants (p < 0.001). Hormonal contraceptive use was associated with less favorable lipid profile patterns and higher Castelli Risk Index values compared with non-users in this study. Although these findings do not establish causality, they highlight the importance of periodic lipid profile evaluation and cardiovascular risk screening among women using hormonal contraceptives, particularly in routine clinical follow-up.