Birth control pill linked to stroke in women, study

Younger women on the oral birth control pill are at high risk of developing stroke, a study carried out at Kenya’s top two referral public hospitals says.

Scientists who recently studied 691 stroke patients at the Kenyatta National Hospital (KNH) and Moi Referral and Teaching Hospital (MRTH) report more women than men are being affected by stroke in Kenya.

Among women aged 30 years and below, the study reports, the oral birth control pill to be a significant risk in developing stroke.

“Important and unexpected observation included significantly higher numbers of women affected by stroke than men,” says the new report.

A stroke occurs when blood flow to the brain is stopped either by a blockage or the rupture of a blood vessel.

The scientists from the Kenya Medical Research Institute (Kemri), KNH and Moi University, Eldoret, say the survey was part of establishing a national stroke registry, the first in Sub-Sahara Africa.

The team also included scientists from Maine Medical Centre in the US and Jomo Kenyatta University of Agriculture and Technology. They studied 691 stroke patients attending KNH and MRTH for a 12-month period, between February 2015 and January 2016. There were 293 males and 398 women.

The report appearing in the current issue of the Cardiovascular Journal of Africa, shows that of 58 stroke patients below 30 years in the study group, 11 were men and 27 women, with 18 per cent reporting to have been on the pill.

The risk of stroke linked to the oral control pill in this study is shown to peak among women aged 30 to 39 years, with 27.9 per cent saying to have used the drug.

Contraceptive use in Kenya is estimated at 58 per cent in women aged 15 to 49 years, with about 10 per cent using the oral pill.

Younger women with HIV were also at a higher risk of suffering from stroke, the study shows. A history of migraine – a headache disorder – the report shows was also likely to be a contributory factor to developing stroke.

Again, this was much higher in women aged below 30 compared to similarly aged males. There were 18 women in this age bracket reporting previous cases of migraine, compared to only four men.

Overall, the report shows the major risk factors for stroke at the country’s two major public hospitals is hypertension followed by tobacco smoking – the latter in men.

A small but significant number of both genders, the study suggests may have developed stroke due to the use of cocaine. The risk of developing stroke increase with age, according to the report.

The team also reported high incidence of diabetes among stroke patients, also shown to increase with age.

Women with high levels of cholesterol were twice more likely than men to have stroke, with bad body fat seen to be a risk factor at all ages.

The study, led by Dr Lydia Kaduka of Kemri says women are also more likely to suffer a recurred stroke. But the team also reports high rates of deaths after stroke, indicating poor treatment outcomes at the two hospitals.

“The post stroke mortality in this study was higher than the average national estimate of 12 per cent, suggesting poor treatment outcomes,” says the report.

By including patients from MRTH, which largely serves a rural population from Western Kenya and the Rift Valley, the team says it found evidence that heart diseases are a problem in both rural and urban areas.

“An important finding of this study is the distribution of stroke and associated risk factors both in rural and urban areas of the country,” said the study.

The team now wants Kenyans to take hypertension treatment seriously as this could reduce cases of stroke by up to 40 per cent.

However, a recent survey by the Ministry of Health showed that only 20 per cent of patients diagnosed with high blood pressure are able to pursue treatment due to the high cost of medicine.

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