OBJECTIVE: Women's cardiovascular risk factors, including inflammatory markers such as C-reactive protein (CRP) which is emerging as a major association with cardiovascular disease (CVD) risk, can be influenced by the oral contraceptive (OC) pill in premenopausal and hormone replacement (HR) in postmenopausal women and by central adiposity which is associated with a heightened inflammatory state. The interaction between central obesity and different hormone use in both pre and postmenopausal women has not previously been reported in a study spanning the whole age range associated with hormone use. DESIGN: Observational, cross-sectional study. PATIENTS: Only healthy women were included in this study. MEASUREMENTS: A total of 21,310 women aged 30-64 employed by Marks & Spencer participated. They completed a health questionnaire and were screened for CVD risk factors including blood pressure, weight, height, waist and hip circumference, lipids and lipoproteins, CRP and fibrinogen. RESULTS: Compared with non-users, women who took the OC or HR had significantly higher CRP levels. This was more marked than effects on other CVD risk factors. It was further compounded by the independent effect of increased waist circumference. The CRP increase was greatest (more than twice that of nonhormone users) in premenopausal women with the highest quartile of waist circumference who took the combined contraceptive pill. CONCLUSIONS: Women who received first the combined OC and then HR may be exposed over much of their life to high CRP levels aggravated by central obesity. The health consequences of this require further investigation.

Original publication




Journal article


Clin Endocrinol (Oxf)

Publication Date





727 - 732


Adult, C-Reactive Protein, Contraceptives, Oral, Cross-Sectional Studies, Estrogen Replacement Therapy, Female, Hormones, Humans, Middle Aged, Obesity, Overweight