Dangerous Combo Could Lead to Stroke

Hormone therapy, high blood pressure may increase risk in postmenopausal women

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MONDAY, Oct. 20, 2003 (HealthDayNews) -- Postmenopausal women with high blood pressure might want to think twice before they try hormone therapy.

The combination could put them at increased risk for stroke, says a Danish study in the October issue of the Archives of Neurology.

The study included 13,122 women nurses older than age 44 who, in 1993, were free of major cardiovascular or cerebrovascular disease and cancer. The nurses were followed until 1998 to check for occurrence of stroke.

Between 1993 and 1998, 144 strokes (46 fatal) were recorded among the women. Of those strokes, 99 were ischemic and 45 were hemorrhagic.

Overall, there was no association between hormone therapy use and risk of stroke. But the study did find that among the 2,256 women with high blood pressure, the risk for stroke was more than twice as high for current hormone therapy users compared with women who never used the treatment.

That risk of stroke was three times higher in hormone therapy users taking an estrogen-progestin combination.

When the study began in 1993, 28 percent of the women were current hormone therapy users, 14.3 percent were past users and 57.7 percent had never used it. The median length of time of hormone therapy use among current users was six years and the median length of time of use among past users was two years.

Among the hormone therapy users, 35.5 percent used unopposed estrogen (estradiol) and 59.2 percent used combination therapy (estrogen combined with norethisterone acetate).

"When assessing whether the presence of risk factors for stroke modified the associations, we found a consistent significantly increased risk of total stroke and various subtypes of stroke associated with the use of [hormone therapy] among hypertensive nurses," the study authors write.

"This risk was most pronounced among nurses using estrogen-progestin therapy. Normotensive nurses using [hormone therapy] had no increased risk of stroke," they add.

More information

Here's where you can learn more about hormone therapy.

SOURCE: JAMA/Archives, news release, Oct. 20, 2003

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