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Can the Pill Kill?

Up to 45% of American women of reproductive age use oral contraception - otherwise known as birth control pills or "the pill" - to prevent unwanted pregnancy. New oral contraceptives have recently been developed to be safer than their predecessors, which were linked to heart attacks.

These third-generation contraceptives have been suggested to actually protect against heart attacks, yet a recent study in The New England Journal of Medicine provided different results.

The study examined the association between first-, second- and third-generation oral contraceptives and heart attacks in the Netherlands. Approximately 250 women who had suffered a heart attack and nearly 1,000 other women who had not were selected for the study. The 18- to 49-year-old women provided information on oral contraceptive use and other heart-attack risk factors.

Using any type of oral contraceptive doubled heart-attack risk. In particular, first-generation oral contraceptives increased heart-attack risk by 2.7 times; second-generation contraceptives increased risk 2.5 times; and third-generation contraceptives increased risk 1.3 times. Risks were highest among women who smoked, had diabetes, or had high levels of "bad" (LDL) cholesterol.

The data for third-generation oral contraceptives are inconclusive. Yet it appears that although they may provide a decreased risk for heart attacks compared to first- and second-generation pills, they may still slightly increase your risk for a heart attack.


Tanis BC, van den Bosch M, Kemmeren JM, et al. Oral contraceptives and the risk of myocardial infarction. The New England Journal of Medicine 2001:345(25), pp. 1787-1793.

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