Risk increases for older women who use combined hormone therapy.

2003 JUN 12 - (NewsRx.com & NewsRx.net) -- Healthy postmenopausal women who take the combination hormone replacement therapy of estrogen plus progestin are at increased risk for stroke, according to a new study.

Stroke is a major health issue for women and cerebrovascular disease is the third leading cause of death in the United States and the leading cause of adult disability. The Women's Health Initiative (WHI) clinical trial, which began in the early 1990s, was designed to examine a number of factors affecting the health of postmenopausal women. One study within the WHI, the clinical trial of estrogen plus progestin, was terminated 3 years before its planned completion date because the harmful effects of hormone therapy outweighed the benefits.

In this study, in the Journal of the American Medical Association, Sylvia Wassertheil-Smoller, PhD, of the Albert Einstein College of Medicine, Bronx, New York, and WHI investigators, assessed the effect of estrogen plus progestin on ischemic and hemorrhagic stroke and in subgroups of participants in WHI. The study was a multicenter double-blind, placebo-controlled, randomized clinical trial involving 16,608 women aged 50-79 years with an average follow-up of 5.6 years. Participants received conjugated equine estrogen 0.625 mg/d, plus medroxyprogesterone acetate, 2.5 mg/d (n=8506) or placebo (n=8102).

The researchers found that 151 (1.8%) patients in the estrogen-plus-progestin group and 107 (1.3%) in the placebo group had strokes, an overall ...