Hormone Therapy And Cerebrovascular Events: A Population-Based Nested Case-Control Study.
Menopause. 2006;13(5):730-736
ABSTRACT
Methods: The study cohort comprised 158,031 women 50-69 years-old
registered in the UK General Practice Research Database between 1991
and 1997. The authors conducted a nested case-control analysis using
all 920 confirmed cases of cerebrovascular events identified during
the follow up (536 of Transient ischemic accident (TIA); 259 of
ischemic stroke; 125 of hemorrhagic stroke) and 10,000 controls.
Results: The Odds ratios (ORs) of TIA, ischemic stroke and hemorrhagic
stroke among women currently using HT were 1.48 (95% Confidence
Interval (CI):1.17-1.87), 1.12 (95%CI:0.78-1.59) and 1.21
(95%CI:0.76-1.93), respectively compared to never users. The overall
risk estimate for having a cerebrovascular event was 1.34
(95%CI:1.11-1.61). The risk of TIA was greater among women using high
doses of estrogen 1.96 (95%CI: 1.34-2.87).
Conclusion: Overall, a small increased risk of stroke associated with
hormone therapy use of comparable magnitude to the one observed in
recent clinical trials was found. The increased risk was more patent
for TIA than for stroke, and was greater at higher doses.
Objective: The relationship between postmenopausal hormone therapy
(HT) and cerebrovascular disease has been examined in several
epidemiological studies and clinical trials with conflicting results.
The authors aimed to evaluate the association between the use of HT
and the incidence of first cerebrovascular event.