Use of oral contraceptives among hypertensive Latinas on the Texas-Mexico border

Hypertension is a contraindication to combined oral contraceptive (COC) use. Among 1,046 oral contraceptive (OC) users in El Paso, Texas, we found approximately 8% were hypertensive. Many were unaware of having hypertension regardless of whether they obtained pills in US clinics or Mexican pharmacies. We aimed to explore barriers to detection and control of hypertension, motivations to continue using OCs among hypertensive OC users, and barriers to access more appropriate contraception.

This study is part of the Border Contraceptive Access Study (BCAS), which recruited 532 El Paso residents who obtained OCs at clinics and 514 El Paso residents who obtained OCs over-the-counter at Mexican pharmacies. We conducted 31 interviews with hypertensive BCAS study participants and 12 with hypertensive COC users who were residents of Ciudad Juarez, Mexico, recruited through local community organizations.

Only seven women were aware of cardiovascular risks associated with taking COCs when hypertensive. Most women checked their blood pressure regularly, although more El Paso residents obtaining pills at Mexican pharmacies said they did not. Mexico residents were better informed about the range of contraceptive options than El Paso residents. Frequently mentioned barriers to switching to other contraceptives were the high cost of sterilization and IUDs, long waiting times for sterilization, and fear of side effects and lack of availability of other methods.

Interventions to inform border residents about risks of hypertensive women taking COCs and widespread blood pressure screening are necessary, as well as efforts to increase the availability of other contraceptives in US and Mexican clinics.