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    Are there non-glycemic benefits of continuous glucose monitoring?


    Does postmenopausal HT impact risk of stroke?

    According to a study published in PLOS Medicine, postmenopausal hormone therapy (HT) is not associated with an increased risk of stroke as long as HT is started early. Type of therapy (combination or estrogen only) was also not found to have a link to increased risk of stroke.

    The study used self-reported data from 5 population-based Swedish cohort studies that were performed between 1987 and 2002. In total, the researchers included cohort data from 88,914 postmenopausal women who had reported on HT use and had no previous cardiovascular disease diagnosis. The authors used Laplace regression to assess crude and multivariable-adjusted associations between HT and stroke risk by estimating percentile differences (PDs) with 95% confidence intervals (CIs). The final adjusted models included age at baseline, level of education, body mass index, smoking status, level of physical activity, and age at menopause onset.

    During median follow-up of 14.3 years, 6371 first-time stroke events were recorded, with 1080 of these being hemorrhagic. After multivariable adjustment, early HT initiation (< 5 years since menopause onset) was associated with a longer stroke-free period than never use (1.00 years; 95% CI 0.42 to 1.57). However, there was no significant increase in time without hemorrhagic stroke (1.52 years; CI -0.32 to 3.37). The authors also found that stroke-free and hemorrhagic stroke-free periods were greatest when HT was initiated approximately 0 to 5 years from the onset of menopause.

    When looking at the differences between type of therapy, single conjugated estrogen HT was associated with a shorter stroke-free (-4.41 years; 95% CI -7.14 to -1.68) and hemorrhagic stroke-free periods (-9.51 years; 95% CI -12.77 to -6.24) than was later HT initiation. Combined HT was associated with a shorter hemorrhagic stroke-free period (-1.97 years; 95% CI -3.81—0.13), but not with a shorter stroke-free period (-1.21 years; 95% CI -3.11 to -0.68).

    The authors noted some limitations to the study. Due to its observational design, there is the possibility of uncontrolled confounding as it is likely that the women who used HT during the time of the baseline investigations were generally more health conscious and from a higher socioeconomic level. They also did not have access to information about the HT dose or the type of progestin used in combination therapy. However, the researchers believe their findings illustrate the need to initiate HT early after the onset of menopause, if it is prescribed, so as to reduce risk of stroke. 

    NEXT - Study: Late puberty affects bone mineral density

    Judith M. Orvos, ELS
    Judith M. Orvos, ELS, is a a BELS-certified medical writer and editor and an editorial consultant for Contemporary OB/GYN.
    Ben Schwartz
    Ben Schwartz is Associate Editor, Contemporary OB/GYN.


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