Pharmacogenetic aspects of the use of oral contraceptives and the risk of thrombosis.

Oral contraceptives are currently used by more than 100 million women in developed countries and are a highly efficacious method to prevent undesired pregnancies. However, oral contraceptives are associated with an increased risk of venous and arterial thrombosis, through changes in blood coagulation and fibrinolysis. In order to reduce such complications, the composition of oral contraceptives has changed over the past decades, both for the dose of oestrogen and the type of progestagen.

Post-menopause is the main risk factor for developing isolated pulmonary hypertension in systemic sclerosis.

In scleroderma patients, isolated pulmonary hypertension (PHT) has been associated with selected HLA haplotypes, severe impairment of the diffusing capacity for carbon monoxide and the diagnosis of CREST. Most patients with CREST have a late-age onset of the disease, corresponding to the perimenopausal or postmenopausal period. We conducted a retrospective cohort study to determine the role of post-menopause and of the other known clinical and biological markers in the development of isolated pulmonary hypertension in Italian patients with systemic sclerosis.