Welcome to InCirculation.net
InCirculation.net is a professional cardiovascular resource intended for a global audience of specialists, generalists, researchers, and other healthcare professionals
Cardiovascular news provides daily news updates to help you stay informed.
Meta-analysis confirms stroke risk with HRT
7 July 2008
MedWire News: Results of a meta-analysis confirm that hormone replacement therapy (HRT) increases women's risk for stroke, but not coronary heart disease (CHD).
"HRT cannot be recommended for long-term vascular prophylaxis in most subjects," Philip Bath (University of Nottingham, UK) and colleagues write in the European Heart Journal.
But they stress: "This does not affect current advice on using HRT during the peri-menopausal period or in women with premature ovarian failure."
The meta-analysis included 31 trials with 44,113 women. The researchers counted the number of women with at least one event, rather than the total number of events.
They explain: "This is important, as many patients suffer more than one event during the course of a trial (ie, a patient with a nonfatal stroke may go on to have a fatal stroke) and the present approach may provide a more accurate estimate of the risk associated with HRT to an individual."
Women taking HRT were 32% more likely to suffer stroke than those who were not. HRT also increased women's risk for suffering a fatal, rather than nonfatal, stroke. However, women taking combined HRT (estrogen and progesterone) were no more likely to suffer stroke than those taking estrogen only.
HRT doubled women's risk for venous thromboembolism (VTE), compared with no therapy, and combined HRT doubled VTE risk compared with monotherapy.
CHD risk was not influenced by whether women took HRT and, in contrast to a previous study, the vascular risk associated with HRT was no more pronounced in younger women (<60 years).
"This analysis provides robust information on the relative risks of arterial and venous vascular events and can be used to help inform the physician and patient. Any increased risk should be taken within the context of the underlying absolute risk for each individual patient, including consideration of other risk factors for vascular disease, and the possible benefits of treatment," the team concludes.
