From the Kaiser Permanente Medical Care Program, Southern California
(D.B.P.) and Northern California (S.S., C.P.Q., A.B.).
Background and Purpose—Information
about the risk of stroke in current postmenopausal hormone users
is limited.
Methods—In this case-control study, women aged 45 to 74 years
hospitalized with a fatal or nonfatal stroke in any of 10 Northern
California Kaiser Permanente facilities during the period November 1991
to November 1994 were identified as cases. Controls were selected at
random from female Health Plan members. Data regarding use of estrogen
plus progestogen or estrogen alone were obtained in interviews.
Results—The analysis was based on nonproxy responses from
349 cases of ischemic stroke and 349 matched control subjects.
After adjustment for confounders, the odds ratio for ischemic
stroke in current hormone users was 1.03 (95% confidence interval,
0.65 to 1.65). The odds ratios for ischemic stroke in current
hormone users showed no clear trend of increasing or decreasing risk in
relation to duration of hormone use. The odds ratio for
ischemic stroke in past hormone users was 0.84 (95% confidence
interval, 0.54 to 1.32).
Conclusions—In this study postmenopausal hormone use was not
associated with an increase or decrease in the risk of ischemic
stroke, a finding that is consistent with the body of
literature on this topic.
© 1998 American Heart Association, Inc.
Original Contributions
Ischemic Stroke and Use of Estrogen and Estrogen/Progestogen as Hormone Replacement Therapy
Key Words: cerebral infarction • cerebrovascular disorders • hemorrhagic stroke • stroke, ischemic
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