Abstract
Objective
The purpose of this study was to examine the risk of first-ever stroke in relation
to use of hormone replacement therapy (HRT) among middle-aged and older Swedish women.
Materials
A total of 16,906 women, 45–73 years old, from the ‘Diet and Cancer’ study in Malmö,
Sweden were examined. Women were considered as HRT users if they took systemic hormone
therapy regularly. Incidence of stroke was followed for a mean period of 10.5 years.
Results
In all, 2148 (12.7%) women used HRT. A total of 461 stroke cases occurred during follow-up,
48 of them in HRT users. Incidence of total stroke and ischemic subtype had no significant
relation to HRT use. However, an increased risk of hemorrhagic stroke was found in
women taking unopposed estrogen (RR = 2.55, 95%CI: 1.03–6.35) or un-native estrogen regimens (RR = 4.27, 95%CI: 1.71–10.66). Although not significantly, the risk of stroke was 33% lower
in women who started their treatment before menopause. Among HRT users, the risk of
stroke was associated with advancing age, smoking, excess body weight and hypertension.
Conclusions
There is no significant association between hormone therapy and risk of total stroke
in women during 10.5 years follow-up. Preparations of estrogen and time for initiation
of treatment may affect the risk of stroke.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to MaturitasAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Reference
- Estrogen plus progestin and the risk of coronary heart disease.N Engl J Med. 2003; 349: 523-534
- Effect of estrogen plus progestin on stroke in postmenopausal women: the Women's Health Initiative. A randomized trial.JAMA. 2003; 289: 2673-2684
- Association between hormone replacement therapy and subsequent stroke: a meta-analysis.BMJ. 2005; 21: 1-4
- A prospective, observational study of postmenopausal hormone therapy and primary prevention of cardiovascular disease.Ann Intern Med. 2000; 133: 933-941
- Decreased risk of stroke among postmenopausal hormone users.Arch Intern Med. 1993; 153: 73-79
- Hormone replacement therapy and the risk of stroke.Arch Intern Med. 1993; 153: 1201-1209
- Design and feasibility.J Intern Med. 1993; 233: 45-51
- Stroke registry in Malmö.Stroke. 1992; 23: 357-361
- Occupational status, educational level, and the prevalence of carotid atherosclerosis in a general population sample of middle-aged Swedish men and women.Am J Epidemiol. 2000; 152: 334-346
The sixth report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997;157:2413–46.
- Understanding the divergent data on postmenopausal hormone therapy.N Engl J Med. 2003; 348: 645-650
- Hormone replacement therapy and associated risk of stroke in postmenopausal women.Arch Intern Med. 2002; 162: 1954-1960
- Hormone replacement therapy and stroke: risk, protection or no effect?.Maturitas. 2001; 38: 243-261
- Postmenopausal hormone therapy and risk of stroke.Circulation. 2001; 103: 638-642
- The natural course of atherosclerosis.Arterioscler Thromb Vasc Biol. 1999; 19: 1484-1490
- Estrogen in the prevention of atherosclerosis.Ann Intern Med. 2001; 135: 939-953
- Effect of oral postmenopausal hormone replacement on progression of atherosclerosis.Arterioscler Thromb Vasc Biol. 2001; 21: 262-268
- Effect of hormone therapy on BP in normotensive and hypertensive postmenopausal women.Maturitas. 2004; 49: 189-203
- Blood pressure changes: oestrogens in climacteric women.Med J Aust. 1981; 2: 528-531
- Risks of estrogens and progestogens.Maturitas. 1990; 12: 215-246
- Blood pressure control and risk of stroke.Stroke. 2005; 36: 725-730
Article info
Publication history
Accepted:
October 10,
2005
Received in revised form:
September 29,
2005
Received:
June 13,
2005
Identification
Copyright
© 2005 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
