Which of the following is a contraindication for combined hormonal contraceptives?

Combined hormonal contraceptives (CHCs) are a popular method of birth control that involve the use of estrogen and progestin. However, certain medical conditions and lifestyle factors can significantly increase the risks associated with their use, particularly cardiovascular risks.

In this context, smoking combined with age over 45 is a well-established contraindication for the use of combined hormonal contraceptives. Smoking is known to increase the risk of thromboembolism, especially when combined with estrogen-containing contraceptives. The risk escalates further with age, particularly after the age of 35, but is notably significant for individuals over 45 who smoke. This combination creates a heightened risk profile, making it unsafe for these individuals to use CHCs due to the increased potential for serious cardiovascular events, such as stroke or deep vein thrombosis.

On the other hand, being under age 30, having a history of migraines without aura, or having normal blood pressure do not directly contraindicate the use of combined hormonal contraceptives. Young age generally carries a lower risk for complications associated with hormonal contraceptives. Migraines that do not have aura are typically considered less risky when it comes to the use of hormonal contraceptives compared to those with aura. Normal blood pressure