Abstract P390: Trends in Contraceptive Prescribing in Women with Hypertension from 2017-2022

Introduction: Estrogen based contraception is not recommended by the U.S. Medical Eligibility Criteria (MEC) in women with hypertension (HTN), regardless of control. While the CDC reports 65.3% of women of child-bearing age use contraception, little is known about rates of contraceptive prescriptions in women with HTN. Purpose: To examine contraceptive prescription patterns among women with and without HTN. Methods: Retrospective review of electronic health record (EHR) data through EPIC from a large health system was performed using a data extraction tool called EPIC SlicerDicer. All women aged 18-55 with HTN who presented to the health system from 2017-2022 were included. HTN, defined by ICD codes, included essential HTN, benign HTN, HTN in CKD due to T2DM, HTN in CKD III due to T2DM, HTN concurrent and due to end stage renal disease, HTN secondary to endocrine disorder, renovascular HTN, HTN with albuminuria, and secondary HTN. Contraceptive prescriptions were abstracted from the EHR including estrogen based contraception (combination oral contraceptive pills, patch, and ring), long acting reversible contraception (intrauterine device or implant), progestin only pills, and depo-provera. Results: Over 5 years, 33.5% (613 of 1,831) of women with HTN were prescribed contraceptives vs. 12.2% of women without HTN (77,742 of 637,820, p < 0.001, Table ). Women with HTN prescribed contraceptives were mean age 43 (SD 9) years, 76.2% White, 9.3% Black, and 16.2% Hispanic/Latina. Women with HTN not prescribed a contraceptive were mean age 48 (7) years (p < 0.001) with similar racial/ethnic background (p = 0.47). Among prescriptions for women with HTN, 37.7% were estrogen based. Conclusions: Women with HTN are prescribed effective contraception at a higher rate compared to the general population. Despite US MEC recommendations, over 1/3 of women with HTN are prescribed estrogen based contraception. Further efforts are warranted to encourage effective contraception counseling and prescription in this high-risk population.