Evidence map›Paper›PMID 41481290›Full record

ArticleJAMA network open2026

Hormonal Contraceptive Use, Stress Disorders, and Cardiovascular and Thrombotic Risk in Women.

Jordan L Thomas, Robyn A Ellis, Krystel AbiKaram, Shady Abohashem, Anahita Dua, Emily S Lau, Maureen J MacDonald, Karen K Miller, Suzanne L Pineles, Rachel P Rosovsky and 3 more

Abstract read
In one paragraph

Article in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jordan L ThomasBehavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts.
Robyn A EllisMcLean Hospital, Belmont, Massachusetts.
Krystel AbiKaramCardiovascular Imaging Research Center, Massachusetts General Hospital, Boston.
Shady AbohashemCardiovascular Imaging Research Center, Massachusetts General Hospital, Boston.
Anahita DuaVascular Center, Massachusetts General Hospital, Boston.
Emily S LauCardiology Division, Department of Medicine, Massachusetts General Hospital, Boston.
Maureen J MacDonaldDepartment of Kinesiology, McMaster University, Hamilton, Ontario, Canada.
Karen K MillerNeuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston.
Suzanne L PinelesDepartment of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
Rachel P RosovskyDivision of Hematology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston.
Ahmed TawakolCardiovascular Imaging Research Center, Massachusetts General Hospital, Boston.
Michael T OsborneCardiovascular Imaging Research Center, Massachusetts General Hospital, Boston.
Antonia V SeligowskiDepartment of Psychiatry, Harvard Medical School, Boston, Massachusetts.

Funding

ROLE OF DIETARY CONSTITUENTS ON GENE EXPRESSION IN INTESTINAL EPITHELIUMP30DK040561 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI Elizabeth Austen Lawson, Takara Leah Stanley · 1994 to 2026
$31.6M
Women's Alzheimer's Risk Reduction in MidlifeP20GM152280 · NIGMS · UNIVERSITY OF KANSAS LAWRENCE · PI Amber Watts · 2024 to 2026
$10.0M
Postdoctoral Training Program in Stress and TraumaT32MH019836 · NIMH · TUFTS UNIVERSITY BOSTON · PI DENISE M. SLOAN · 1996 to 2026
$4.7M
Menopause-related Vasomotor Symptoms and Cardiovascular HealthR01HL180648 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI Emily Lau · 2025 to 2026
$1.5M
HFpEF Susceptibility in Women: The Role of InflammationK23HL159243 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI Emily Lau · 2022 to 2026
$1.1M
NHLBI NIH HHS K23 HL159243NHLBI NIH HHS R01 HL180648NIDDK NIH HHS P30 DK040561NIGMS NIH HHS P20 GM152280NIMH NIH HHS T32 MH019836
6 · The paper itself

Abstract

Importance: Stress and its psychiatric consequences-including depression, anxiety, and posttraumatic stress disorder (PTSD)-are pertinent to women's cardiovascular health, but research on intersections with relevant sex-specific factors (eg, hormonal contraceptives) is lacking. Objective: To examine whether stress-related psychiatric diagnoses moderate associations between hormonal contraceptive use and cardiovascular and thrombotic risk. Design, Setting, and Participants: This retrospective cohort study included electronic health record data collected from a US hospital-based biobank and analyzed from May 2, 2024, to November 3, 2025. Participants were women aged 18 to 55 years who consented into the biobank before or on September 12, 2020. Exposures: Lifetime history of stress-related psychiatric disorders, including depression (major depressive disorder), anxiety (generalized anxiety disorder, social anxiety disorder, or panic disorder), and PTSD, defined by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes and analyzed as separate diagnoses, and lifetime history of combined hormonal contraceptive use, defined by RxNorm codes. Main Outcomes and Measures: The primary outcomes were major adverse cardiovascular events (MACE; defined as ICD-10 codes for infarction, unstable angina, heart failure, coronary revascularization, peripheral vascular disease, peripheral revascularization, stroke, and/or transient ischemic attack) and deep-vein thrombosis (DVT). Three 2-step hierarchical logistic regressions per outcome were conducted. Results: In this sample of 31 824 women (mean [SD] age, 38.5 [10.6] years), over one-third (11 950 women [37.6%]) had hormonal contraceptive use history, and stress-related disorders were common (depression, 9116 women [28.5%]; anxiety, 3533 women [11.1%]; PTSD, 1992 women [6.3%]). Associations were mixed across the stress-related disorders, in that depression and anxiety did not moderate associations between contraceptive use and MACE or DVT. In contrast, PTSD modified the association between contraceptive use and MACE but not that between contraceptive use and DVT. Analyses stratified by PTSD status found that only women without PTSD using contraceptives had lower odds for MACE (odds ratio, 0.69; 95% CI, 0.87-3.24). The odds ratio for MACE among women with PTSD was greater than 1, but the finding was not statistically significant (odds ratio, 1.68; 95% CI, 0.87-3.24). Conclusions and Relevance: In this retrospective cohort study, combined hormonal contraceptive use was associated with lower cardiovascular risk in women regardless of depression or anxiety. These protective associations did not extend to women with PTSD, suggesting that there are unique cardiovascular processes in the context of this stress-related disorder and hormonal contraceptive use that warrant further research.

Indexed as

Cardiovascular DiseasesContraceptives, Oral, HormonalStress Disorders, Post-TraumaticThrombosisAdolescentAdultAnxiety DisordersFemaleHumansMiddle AgedRetrospective StudiesRisk FactorsUnited StatesYoung AdultContraceptives, Oral, Hormonal

Identifiers

PMID41481290
PMCPMC12761333

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.