Menopausal Hormone Therapy and the Risk of Stroke: A Nationwide Cohort Study.

IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Sung Pil Choo, Hyunji Park, Hyemin Park, Inha Lee, Sihyun Cho, Changsoo Kim, Kyung-Yul Lee, Jae Hoon Lee, Jong-Youn Kim
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Abstract

Purpose: Most studies have reported that the risk of coronary heart disease decreases when menopausal hormone therapy (MHT) is initiated before the age of 60 years or within 10 years of menopause. However, the findings regarding stroke risk remain conflicting. This study investigated the association between the risk of ischemic stroke and MHT, categorized by the type of MHT.

Materials and methods: This population-based, retrospective cohort study was based on the Korean National Health Insurance Service-National Sample Cohort (2004-2015). Participants were aged 45-60 years with no cardiovascular disease or preexisting stroke, classified as never, past, and current users of MHT.

Results: Among the study participants, 16915 (88.77%) women had never undergone MHT, 1437 (7.54%) had previously undergone MHT, and 703 (3.69%) were currently using MHT. During the study period, with a mean follow-up of 11.23±2.13 years, the risk of ischemic events was significantly higher among current users [hazard ratio (HR): 2.98, 95% confidence interval (CI): 1.95-4.57, p<0.001], particularly in those using estrogen-only MHT (HR: 3.49, 95% CI: 1.12-10.90, p=0.032) and tibolone (HR: 3.52, 95% CI: 2.05-6.03, p<0.001), compared to never users. Meanwhile, no significant difference in the risk of ischemic events was observed between past users and never users, even after analyses accounting for estrogen type and progestin co-administration.

Conclusion: Women currently receiving MHT without underlying cardiovascular disease exhibited an increased risk of ischemic stroke, particularly those treated with E-only MHT or tibolone. However, this increased risk returned to baseline after discontinuing MHT, indicating that past use of MHT was not associated with an increased risk of ischemic stroke.

绝经期激素治疗与卒中风险:一项全国性队列研究。
目的:大多数研究报道,绝经期激素治疗(MHT)在60岁前或绝经后10年内开始可降低冠心病的风险。然而,关于中风风险的研究结果仍然相互矛盾。本研究调查了缺血性卒中风险与MHT之间的关系,并根据MHT的类型进行了分类。材料和方法:这项以人群为基础的回顾性队列研究基于韩国国民健康保险服务-国家样本队列(2004-2015)。参与者年龄在45-60岁之间,无心血管疾病或先前存在的中风,分为从未、过去和现在使用MHT。结果:在研究参与者中,16915名(88.77%)女性从未接受过MHT, 1437名(7.54%)女性曾经接受过MHT, 703名(3.69%)女性正在接受MHT。在研究期间,平均随访时间为11.23±2.13年,目前使用MHT的患者(HR: 2.98, 95%可信区间(CI): 1.95-4.57, pp=0.032)和替博龙(HR: 3.52, 95% CI: 2.05-6.03, p)发生缺血性卒中的风险明显更高,结论:目前接受MHT的无潜在心血管疾病的女性发生缺血性卒中的风险增加,特别是仅接受e - MHT或替博龙治疗的女性。然而,在停止MHT后,这种增加的风险又回到了基线,这表明过去使用MHT与缺血性卒中风险增加无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Yonsei Medical Journal
Yonsei Medical Journal 医学-医学:内科
CiteScore
4.50
自引率
0.00%
发文量
167
审稿时长
3 months
期刊介绍: The goal of the Yonsei Medical Journal (YMJ) is to publish high quality manuscripts dedicated to clinical or basic research. Any authors affiliated with an accredited biomedical institution may submit manuscripts of original articles, review articles, case reports, brief communications, and letters to the Editor.
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