{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T02:05:39Z","timestamp":1782698739316,"version":"3.54.5"},"reference-count":27,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T00:00:00Z","timestamp":1674000000000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,1,3]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The use of oral contraceptives (OCs) is linked to an increased risk of cardiovascular diseases (CVDs) in women of reproductive age. CVD remain one of the top causes of death worldwide, with at least three-quarters of deaths occurring in low-income and middle-income nations. The impact of various types of combined oral contraceptive (COC) on several modifiable risk factors associated with CVDs in premenopausal women is inconsistent regardless of genetic mutations. The aim of this systematic review will be to provide a comprehensive synthesis of the available evidence on the impact of COC usage on modifiable risk factors associated with CVDs and assess ethnic and geographic disparities in the reported prevalence of CVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This systematic review protocol was prepared in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols 2015 statement. An extensive search on the Embase, MEDLINE and Cochrane Library will be conducted from inception until. Two reviewers will independently screen for eligible studies using a predefined criterion. The risk of bias and quality of included studies will be assessed using the modified Downs and Black\u2019s checklist. Whereas the overall quality of included studies will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation assessment tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This is a review of existing studies and will not require ethical approval. The findings will be disseminated through peer-reviewed publication. The use of OC and the risk of CVDs including arterial and venous thrombosis remain a major concern among women of reproductive age. Thus, given the impact of COCs on the risk variables linked with CVDs, this review may provide an insight and assistance during COC use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42020216169.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-071118","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T01:12:43Z","timestamp":1674090763000},"page":"e071118","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Investigating the risks of cardiovascular disease among premenopausal women using oral contraceptive: a protocol for a systematic review and meta-analysis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3005-331X","authenticated-orcid":false,"given":"Oyesanmi A","family":"Fabunmi","sequence":"first","affiliation":[{"name":"Human Physiology, School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa"},{"name":"Human Physiology, College of Medicine, Ekiti State University, Ado Ekiti, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phiwayinkosi V","family":"Dludla","sequence":"additional","affiliation":[{"name":"Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siphamandla R","family":"Ngcobo","sequence":"additional","affiliation":[{"name":"Human Physiology, School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8846-1992","authenticated-orcid":false,"given":"Bongani B","family":"Nkambule","sequence":"additional","affiliation":[{"name":"Human Physiology, School of Laboratory Medicine and Medical Sciences (SLMMS), College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,18]]},"reference":[{"key":"2025121400251648000_13.1.e071118.1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1076029616683802","article-title":"Oral contraceptives and HRT risk of thrombosis","volume":"24","author":"Gialeraki","year":"2018","journal-title":"Clin Appl Thromb Hemost"},{"key":"2025121400251648000_13.1.e071118.2","doi-asserted-by":"crossref","first-page":"H77","DOI":"10.1152\/ajpheart.00614.2020","article-title":"Influence of hormonal contraceptives on peripheral vascular function and structure in premenopausal females: a review","volume":"320","author":"Williams","year":"2021","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2025121400251648000_13.1.e071118.3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.beem.2012.11.004","article-title":"History of oral contraceptive drugs and their use worldwide","volume":"27","author":"Christin-Maitre","year":"2013","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"2025121400251648000_13.1.e071118.4","unstructured":"Population Division UN . 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