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Title: Hormone Therapy May Increase Risk of Stroke in Postmenopausal Women
URL: http://www.pslgroup.com/dg/2204CE.htm
Doctor's Guide
April 28, 2008

CHICAGO -- April 28, 2008 -- Postmenopausal women taking hormone therapy appear to have an increased risk of stroke regardless of when they started treatment, according to a report in the April 28 issue of Archives of Internal Medicine. Previous studies have analysed the risk of stroke from hormone therapy, but these studies did not determine stroke risk for younger women taking hormone therapy near the onset of menopause.

Francine Grodstein, ScD, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and colleagues evaluated stroke risk associated with hormone therapy in 121,700 women (aged 30 to 55 years at the beginning of the study) who participated in the Nurses' Health Study from 1976 to 2004. There were 360 cases of stroke among women who had never used hormones and 414 cases of stroke among women who were currently using hormones.

Compared with women who had never used hormones, women currently taking hormone therapy had an increased risk for stroke (39% for those taking oestrogen and 27% for those taking oestrogen with progestin). "This increased risk was observed for women initiating hormone therapy at young ages or near menopause and at older ages or more than 10 years after menopause," the authors noted. Taking hormone therapy for less than 5 years at younger ages was not linked to a clear increase in stroke, possibly due to the small number of cases.

"The incidence of stroke was relatively low in younger women, and the attributable risk in women aged 50 through 54 years indicated approximately an additional 2 cases of stroke per 10,000 women per year taking hormones," the authors noted. They also found a strong relationship between oestrogen dose and stroke, with larger doses increasing the risk.

"Our findings in the Nurses′ Health Study indicate that hormone therapy is associated with an increased risk of stroke, regardless of the hormone regimen or the timing of hormone therapy initiation," the authors concluded. "However, in younger women, who are at lower absolute risk of stroke, the attributable risk of stroke owing to hormone use is modest, and our data suggest that risk might be further minimized by lower doses and shorter duration of treatment."

SOURCE: Archives of Internal Medicine

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