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Low estradiol tied to reduced stroke risk.(News)
KISSIMMEE, FLA. -- Serum endogenous estradiol levels in postmenopausal women appear to affect stroke risk, and raloxifene treatment may reduce that risk in patients with high levels of the naturally occurring estrogen, Dr. Jennifer S. Lee reported at the 31st International Stroke Conference.
The findings were based on an analysis of data from the Multiple Outcomes of Raloxifene Evaluation (MORE) trial, which was originally designed to test the effects of 60 mg and 120 mg of raloxifene--a selective estrogen-receptor modulator marketed as Evista by Eli Lilly and Co.--on bone mineral density and vertebral fractures in postmenopausal women. The 4-year, randomized, double-blind trial involved women with osteoporosis who were at least 2 years postmenopausal, were aged 80 years or younger, and who had no history of stroke or venous thromboembolic disease in the prior 10 years.
In 7,290 women from that trial who had baseline measures of serum endogenous estradiol, low levels (10 pmol/L or less) were associated with a 70% reduction in stroke risk, compared with those with higher levels, regardless of whether patients were taking raloxifene or placebo, said Dr. Lee of the California Pacific Medical Center Research Institute in San Francisco.
Overall, the stroke risk did not differ among those taking placebo or raloxifene, with 32 of 2,437 patients (1.3%) in the placebo group and 48 of 4,843 patients (1%) in the raloxifene group experiencing stroke.
The effect of the drug is sometimes to boost and sometimes to block the effects of estrogen, depending on the tissue in question. In the brain, estradiol has a blunting effect on estrogen. The stroke risk of those in the highest quartile of serum endogenous estradiol levels (16 pmol/L or greater) was 2.5 times higher than in those with levels below 16 pmol/L, and this risk was reduced by 55% in those taking raloxifene, compared with those taking placebo.
Raloxifene treatment had no effect on stroke risk in those with the lower estradiol levels. That is, stroke occurred in 15 of 1,828 women (0.82%) with levels less than 16 pmol/L who were ...
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Source: HighBeam Research, Low estradiol tied to reduced stroke risk.(News)