Decreased Risk of Stroke Among Postmenopausal Hormone Users

Finucane, Fanchon F.; Madans, Jennifer H.; Bush, Trudy L.; Wolf, Pamela H.; Kleinman, Joel C.

doi:10.1001/archinte.1993.00410010097008

Cited by 186 publications

(21 citation statements)

References 27 publications

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“…26,27 These observations have been interpreted as probable evidence that female reproductive hormones provide vascular protection in ischemic heart disease and stroke. However, it is unclear whether estrogens per se are critical for modulating the risk of stroke or which mechanism provides protection.…”

Section: Discussionmentioning

confidence: 97%

Age and Sex Differences in Cerebral Hemodynamics

Matteis

Troisi

Monaldo

et al. 1998

Stroke

144

121

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Background and Purpose-Hemodynamic factors seem to play an important role in the pathogenesis of cerebral ischemic events. The aim of this study was to evaluate whether changes in cerebrovascular reactivity occur in women after menopause. Methods-Using transcranial Doppler ultrasonography, we studied the changes of flow velocity after hypercapnia in the middle cerebral arteries of 45 healthy premenopausal women (mean age, 32.3 years; range, 20 to 47 years) and 40 postmenopausal women (mean age, 54.4 years; range, 48 to 64 years). The same measurements were recorded in two groups of healthy male subjects age matched with premenopausal (45 subjects) and postmenopausal women (40 subjects). Moreover, a subgroup of postmenopausal women aged 48 to 53 years (15 subjects) were compared with a group of 15 premenopausal women of the same age. We obtained hypercapnia with breath holding and evaluated cerebrovascular reactivity with the breath-holding index (BHI). Results-BHI was significantly lower in postmenopausal women (0.89Ϯ0.3) than in premenopausal women (1.59Ϯ0.3;PϽ0.0001) and in young (1.34Ϯ0.5; PϽ0.001) and old men (1.20Ϯ0.4; PϽ0.04). In the latter group, BHI was significantly lower than in premenopausal women (PϽ.0001). BHI values were also significantly lower in postmenopausal than in premenopausal women of the same age (0.81Ϯ0.1 versus 1.34Ϯ0.1; PϽ0.0001). Conclusions-These findings suggest that the large reduction of cerebrovascular reactivity in postmenopausal women cannot be considered a simple factor related to aging but is probably influenced by hormonal changes. The alteration in cerebrovascular regulation could be involved in the increase of cerebrovascular disease in postmenopausal women.(Stroke. 1998;29:963-967.)

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Section: Discussionmentioning

confidence: 97%

Age and Sex Differences in Cerebral Hemodynamics

Matteis

Troisi

Monaldo

et al. 1998

Stroke

144

121

View full text Add to dashboard Cite

show abstract

“…226 In other studies, the relative risk of stroke among hormone replacement therapy users varied from 0.23 to 1.46, with the relative risk of fatal stroke ranging from 0.30 to 1.40. 170,192,[227][228][229][230][231][232][233][234][235][236][237][238][239] A review indicated a neutral effect of postmenopausal hormone replacement therapy, with a relative risk of 0.96. 240 However, the studies conducted to date have had methodological limitations.…”

Section: Hormone Replacement Therapymentioning

confidence: 99%

Primary Prevention of Ischemic Stroke

Goldstein¹,

Adams²,

Becker³

et al. 2001

Circulation

405

196

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“…Postmenopausal estrogen use has been associated with increased 22,26 and decreased 27,28 risks and no net benefit for stroke prevention. 29 -32 The NIH-sponsored Women's Estrogen for Stroke Trial (WEST) 33 compared 17␤-estradiol (1 mg/d) to placebo in postmenopausal women with a recent history of transient ischemic attack or ischemic stroke.…”

Section: Secondary Prevention After Strokementioning

confidence: 99%