Ischemic stroke and use of estrogen and estrogen/progestogen as hormone replacement therapy

• Published in: Stroke (1970) Vol. 29; no. 1; pp. 23 - 28
• Main Authors: PETITTI, D. B, SIDNEY, S, QUESENBERRY, C. P, BERNSTEIN, A
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 1998; American Heart Association, Inc
• Subjects: Age Factors; Aged; Biological and medical sciences; Body Mass Index; Brain Ischemia - etiology; Case-Control Studies; Cause of Death; Cerebral Hemorrhage - etiology; Cerebral Infarction - etiology; Cerebrovascular Disorders - etiology; Confidence Intervals; Confounding Factors (Epidemiology); Diabetes Complications; Educational Status; Estrogen Replacement Therapy; Estrogens - therapeutic use; Ethnic Groups; Female; Hormones. Endocrine system; Hospitalization; Humans; Hypertension - complications; Ischemic Attack, Transient - complications; Medical sciences; Middle Aged; Odds Ratio; Pharmacology. Drug treatments; Postmenopause; Progestins - therapeutic use; Retrospective Studies; Risk Factors; Smoking - adverse effects; Human; Nervous system diseases; Stroke; Estrogen; Cardiovascular disease; Epidemiology; Cerebral disorder; Vascular disease; Chemotherapy; Ischemia; Central nervous system disease; Risk factor; Postmenopause; Progesterone; Cerebrovascular disease; Brain (vertebrata)
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.29.1.23

Information about the risk of stroke in current postmenopausal hormone users is limited.
In this case-control study, women aged 45 to 74 years hospitalized with a fatal or nonfatal stroke in any of 10 Northern California Kaiser Permanente facilities during the period November 1991 to November 1994 were identified as cases. Controls were selected at random from female Health Plan members. Data regarding use of estrogen plus progestogen or estrogen alone were obtained in interviews.
The analysis was based on nonproxy responses from 349 cases of ischemic stroke and 349 matched control subjects. After adjustment for confounders, the odds ratio for ischemic stroke in current hormone users was 1.03 (95% confidence interval, 0.65 to 1.65). The odds ratios for ischemic stroke in current hormone users showed no clear trend of increasing or decreasing risk in relation to duration of hormone use. The odds ratio for ischemic stroke in past hormone users was 0.84 (95% confidence interval, 0.54 to 1.32).
In this study postmenopausal hormone use was not associated with an increase or decrease in the risk of ischemic stroke, a finding that is consistent with the body of literature on this topic.