{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:55:29Z","timestamp":1792612529532,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1178,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Obesity and oestrogen containing contraceptive products are well-known independent cardiovascular risk factors. However, a significant number of obese women continue to receive prescriptions of hormonal products that contain oestrogens for their contraception. We have conducted a narrative review to discuss the latest evidence, ongoing research, and controversial issues on the synergistic effect of obesity and contraceptive use, in terms of cardiovascular risk. There is compelling evidence of an interplay between obesity and contraception in increasing cardiovascular risk. Women who present both obesity and use of combined oral contraceptives (COCs) have a greater risk (between 12 and 24 times) to develop venous thromboembolism than non-obese non-COC users. Data here discussed offer new insights to increase clinicians' awareness on the cardiovascular risk in the clinical management of obese women. The synergistic effect of obesity and COCs on deep venous thrombosis risk must be considered when prescribing hormonal contraception. Progestin-only products are a safer alternative to COCs in patients with overweight or obesity. Obese women taking contraceptives should be viewed as an \u2018at risk\u2019 population, and as such, they should receive advice to change their lifestyle, avoiding other cardiovascular risk factors, as a form of primary prevention. This indication should be extended to young women, as data show that COCs should be avoided in obese women of any age.<\/jats:p>","DOI":"10.1002\/ehf2.14104","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T19:05:12Z","timestamp":1663182312000},"page":"3761-3767","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Obesity and Contraceptive Use: Impact on Cardiovascular Risk"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6868-4248","authenticated-orcid":false,"given":"Giuseppe M.C.","family":"Rosano","sequence":"first","affiliation":[{"name":"Centre for Clinical and Basic Research, Department of Medical Sciences, IRCCS San Raffaele Pisana , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8742-9843","authenticated-orcid":false,"given":"Maria Angeles","family":"Rodriguez-Martinez","sequence":"additional","affiliation":[{"name":"Freelance Consultant of Pharmacovigilance and Clinical Development , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8135-7479","authenticated-orcid":false,"given":"Ilaria","family":"Spoletini","sequence":"additional","affiliation":[{"name":"Centre for Clinical and Basic Research, Department of Medical Sciences, IRCCS San Raffaele Pisana , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9551-2847","authenticated-orcid":false,"given":"Pedro Antonio","family":"Regidor","sequence":"additional","affiliation":[{"name":"Exeltis Healthcare , Ismaning ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"2026012114131370700_ehf214104-bib-0001","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1111\/jth.13369","article-title":"C-reactive protein, obesity, and the risk of arterial and venous thrombosis","volume":"14","author":"Horvei","year":"2016","journal-title":"J Thromb Haemost"},{"key":"2026012114131370700_ehf214104-bib-0002","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/j.contraception.2016.04.014","article-title":"Progestin-only contraception and thromboembolism: A systematic review","volume":"94","author":"Tepper","year":"2016","journal-title":"Contraception"},{"key":"2026012114131370700_ehf214104-bib-0003","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1038\/sj.ijo.0802713","article-title":"Association between C-reactive protein, metabolic cardiovascular risk factors, obesity and oral contraceptive use in young adults","volume":"28","author":"Williams","year":"2004","journal-title":"Int J Obes Relat Metab Disord"},{"key":"2026012114131370700_ehf214104-bib-0004","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1055\/s-0036-1592333","article-title":"Environmental and genetic risk factors associated with venous thromboembolism","volume":"42","author":"Crous-Bou","year":"2016","journal-title":"Semin Thromb Hemost"},{"key":"2026012114131370700_ehf214104-bib-0005","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1111\/j.1538-7836.2007.02450.x","article-title":"Incidence and mortality of venous thrombosis: A population-based study","volume":"5","author":"N\u00e6ss","year":"2007","journal-title":"J Thromb Haemost"},{"key":"2026012114131370700_ehf214104-bib-0006","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11239-015-1311-6","article-title":"The epidemiology of venous thromboembolism","volume":"41","author":"Heit","year":"2016","journal-title":"J Thromb Thrombolysis"},{"key":"2026012114131370700_ehf214104-bib-0007","volume-title":"The top 10 causes of death","author":"World Health Organization","year":"2020."},{"key":"2026012114131370700_ehf214104-bib-0008","doi-asserted-by":"crossref","first-page":"153","DOI":"10.2174\/1573403X14666180222102312","article-title":"Management of Measurable Variable Cardiovascular Disease' risk factors","volume":"14","author":"Fran\u010dula-Zaninovi\u0107","year":"2018","journal-title":"Curr Cardiol Rev"},{"key":"2026012114131370700_ehf214104-bib-0009","doi-asserted-by":"crossref","first-page":"499","DOI":"10.4236\/ojpm.2012.24069","article-title":"The effects of obesity on venous thromboembolism: A review","volume":"2","author":"Yang","year":"2012","journal-title":"Open J Prev Med"},{"key":"2026012114131370700_ehf214104-bib-0010","volume-title":"Obesity and overweight","author":"World Health Organization","year":"2021"},{"key":"2026012114131370700_ehf214104-bib-0011","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1161\/CIRCULATIONAHA.109.863241","article-title":"Anthropometry, body fat, and venous thromboembolism. A Danish follow-up study","volume":"120","author":"Severinsen","year":"2009","journal-title":"Circulation"},{"key":"2026012114131370700_ehf214104-bib-0012","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1016\/j.amjmed.2005.03.012","article-title":"Obesity as a risk factor in venous thromboembolism","volume":"118","author":"Stein","year":"2005","journal-title":"Am J Med"},{"key":"2026012114131370700_ehf214104-bib-0013","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.d6423","article-title":"Risk of venous thromboembolism from use of oral contraceptives containing different progestogens and oestrogen doses: Danish cohort study, 2001-9","volume":"343","author":"Lidegaard","year":"2011","journal-title":"BMJ"},{"key":"2026012114131370700_ehf214104-bib-0014","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.h2135","article-title":"Use of combined oral contraceptives and risk of venous thromboembolism: Nested case-control studies using the QResearch and CPRD databases","volume":"350","author":"Vinogradova","year":"2015","journal-title":"BMJ"},{"key":"2026012114131370700_ehf214104-bib-0015","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.e2990","article-title":"Venous thrombosis in users of non-oral hormonal contraception: Follow-up study, Denmark 2001-10","volume":"344","author":"Lidegaard","year":"2012","journal-title":"BMJ"},{"key":"2026012114131370700_ehf214104-bib-0016","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1055\/s-0031-1297369","article-title":"Obesity and venous thrombosis: A review","volume":"37","author":"Allman-Farinelli","year":"2011","journal-title":"Semin Thromb Hemost"},{"key":"2026012114131370700_ehf214104-bib-0017","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.soard.2020.10.025","article-title":"The role of bariatric surgery in normalization of the coagulation profiles","volume":"17","author":"Farraj","year":"2021","journal-title":"Surg Obes Relat Dis"},{"key":"2026012114131370700_ehf214104-bib-0018","doi-asserted-by":"crossref","first-page":"4029","DOI":"10.1007\/s11695-019-04084-z","article-title":"Assessment of contraceptive counseling and contraceptive use in women after bariatric surgery","volume":"29","author":"Damhof","year":"2019","journal-title":"Obes Surg"},{"key":"2026012114131370700_ehf214104-bib-0019","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/j.1538-7836.2010.04148.x","article-title":"Hormone therapies and venous thromboembolism: Where are we now?","volume":"9","author":"Van Hylckama","year":"2011","journal-title":"J Thromb Haemost"},{"key":"2026012114131370700_ehf214104-bib-0020","doi-asserted-by":"crossref","first-page":"2257","DOI":"10.1056\/NEJMoa1111840","article-title":"Thrombotic stroke and myocardial infarction with hormonal contraception","volume":"366","author":"Lidegaard","year":"2012","journal-title":"N Engl J Med"},{"key":"2026012114131370700_ehf214104-bib-0021","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1177\/2047487318774847","article-title":"Association between progestin-only contraceptive use and cardiometabolic outcomes: A systematic review and meta-analysis","volume":"25","author":"Glisic","year":"2018","journal-title":"Eur J Prev Cardiol"},{"key":"2026012114131370700_ehf214104-bib-0022","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1186\/s12905-020-01080-9","article-title":"Efficacy and cardiovascular safety of the new estrogen-free contraceptive pill containing 4 mg drospirenone alone in a 24\/4 regime","volume":"20","author":"Palacios","year":"2020","journal-title":"BMC Womens Health"},{"key":"2026012114131370700_ehf214104-bib-0023","doi-asserted-by":"crossref","DOI":"10.3390\/molecules26041070","article-title":"Oxidative stress is increased in combined oral contraceptives users and is positively associated with high-sensitivity C-reactive protein","volume":"26","author":"Cauci","year":"2021","journal-title":"Molecules"},{"key":"2026012114131370700_ehf214104-bib-0024","first-page":"S376","article-title":"Overview of venous thromboembolism","volume":"23","author":"Phillippe","year":"2017","journal-title":"Am J Manag Care"},{"key":"2026012114131370700_ehf214104-bib-0025","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.contraception.2016.06.010","article-title":"Impact of estrogen type on cardiovascular safety of combined oral contraceptives","volume":"94","author":"Dinger","year":"2016","journal-title":"Contraception"},{"key":"2026012114131370700_ehf214104-bib-0026","doi-asserted-by":"crossref","first-page":"75","DOI":"10.2147\/OAJC.S179673","article-title":"Venous thrombosis and hormonal contraception: what's new with estradiol-based hormonal contraceptives?","volume":"9","author":"Fruzzetti","year":"2018","journal-title":"Open Access J Contracept"},{"key":"2026012114131370700_ehf214104-bib-0027","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1080\/13625180008500402","article-title":"The effects of age, body mass index, smoking, and general health on the risk of venous thromboembolism in users of combined oral contraceptives","volume":"5","author":"Nightingale","year":"2000","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"2026012114131370700_ehf214104-bib-0028","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1055\/s-0037-1613379","article-title":"Obesity: Risk of venous thrombosis and the interaction with coagulation factor levels and oral contraceptive use","volume":"89","author":"Abdollahi","year":"2003","journal-title":"Thromb Haemost"},{"key":"2026012114131370700_ehf214104-bib-0029","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.1365-2141.2007.06780.x","article-title":"Risk of venous thrombosis: Obesity and its joint effect with oral contraceptive use and prothrombotic mutations","volume":"139","author":"Pomp","year":"2007","journal-title":"Br J Haematol"},{"key":"2026012114131370700_ehf214104-bib-0030","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.contraception.2016.05.014","article-title":"Combined hormonal contraceptive use among obese women and risk for cardiovascular events: A systematic review","volume":"94","author":"Horton","year":"2016","journal-title":"Contraception"},{"key":"2026012114131370700_ehf214104-bib-0031","volume-title":"UK medical eligibility for contraceptive use","author":"Faculty of Sexual & Reproductive Health-Care","year":"2016"},{"key":"2026012114131370700_ehf214104-bib-0032","first-page":"1","article-title":"US medical eligibility criteria for contraceptive use. 2010: Adapted from the World Health Organization medical eligibility criteria for contraceptive use, 4th ed","volume":"59","author":"Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion: Centers for Disease Control and Prevention (CDC)","year":"2010","journal-title":"MMWR Recomm Rep"},{"key":"2026012114131370700_ehf214104-bib-0033","volume-title":"Medical Eligibility Criteria for Contraceptive Use","author":"World Health Organization","year":"2015."}],"updated-by":[{"DOI":"10.1002\/ehf2.14322","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000}}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.14104","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.14104","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/6\/3761\/65347547\/eschf_9_6_3761.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/6\/3761\/65347547\/eschf_9_6_3761.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:15:06Z","timestamp":1769022906000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/9\/6\/3761\/8322776"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,14]]},"references-count":33,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,9,14]]},"published-print":{"date-parts":[[2022,12,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14104","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,12]]},"published":{"date-parts":[[2022,9,14]]},"assertion":[{"value":"2021-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}