More risks with hormone therapy

The latest analysis of data from the Nurses' Health Study (NHS) suggests that hormone therapy is associated with an increased risk for stroke, regardless of the treatment strategy or the timing of treatment initiation.

This is concerning since hormone therapy was once touted to have protective benefits and physicians were encouraged to place women on hormones for the cardiovascular and bone benefits.

This study found an increased risk of approximately 40% with estrogen alone and 30% with estrogen plus progestin and is nearly identical to that of the Women's Health Initiative study published previously.

This NHS is a prospective, observational study including 121,700 women who were between the ages of 30 and 55 years in 1976 and the subjects were observed with biennial questionnaires, including information on menopause and postmenopausal hormone use as well as cardiovascular risk factors and cardiovascular diagnoses.

Overall, this is a large sample group with good observational data and the bottom line of the results is:

• Use of hormone therapy (HT) by postmenopausal women is associated with overall increased risk for stroke of 30% to 40%.
• An increased risk for stroke associated with HT use in postmenopausal women is independent of age of initiation of HT and greater with higher doses of estrogen and older age.