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Early HT initiation not linked to stroke risk in postmenopausal women
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The risk for stroke in postmenopausal women was not increased with hormone therapy —regardless of administration route, type of therapy or active substance — when initiated within 5 years of menopause onset, study data show.
“New research shows us that hormone therapy actually has a positive effect on blood vessels if initiated early on in the menopause, but not if initiated late,” Karin Leander, PhD, senior researcher at the Institute of Environmental Medicine, Karolinska Institutet in Stockholm, said in a press release. “So, there was reason to re-examine whether hormone therapy is linked to the risk of stroke, taking, of course, the time of administering into consideration.”
Leander and colleagues evaluated data from five population-based Swedish cohort studies on 88,914 postmenopausal women who reported data on HT use between 1987 to 2002 to determine the association between HT and risk for stroke when considering timing of initiation, route of administration, type and active ingredient. Median follow-up was 14.3 years.
A 5-year cutoff was used to describe early ( 5 years) or late (> 5 years) HT initiation.
Overall, 7% of participants experienced an incident stroke, 17% of which were hemorrhagic strokes.
After multivariable adjustment, a longer stroke-free period was associated with early HT initiation compared with never use; however, no association was observed between timing and hemorrhagic stroke incidence. Late initiation of HT was associated with shorter stroke-free and hemorrhagic stroke-free periods compared with never use when a single conjugated equine estrogen was used. The hemorrhagic stroke-free period was shorter with combined HT when initiated late compared with never use, but there was no effect on the comprehensive stroke-free period.
“The risk of stroke seems virtually eradicable if treatment commences early, but it’s naturally important to take account of the increase in risk that exists under certain circumstances,” Leander said. “These results provide doctors with a better scientific base on which to take decisions on treatment for menopausal symptoms.” – by Amber Cox
Disclosures: The authors report no relevant financial disclosures.
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