Some HRT Regimens May Increase Risk of Postmenopausal Stroke – (01-08-01)



Some HRT Regimens May Increase Risk of Postmenopausal Stroke

Okay, okay…so why would someone want to take HRT again?? I just cannot figure it out. Reasons for taking HRT are several. Lowering risk of heart disease is one of these reasons; and yet research may indeed be pointing to an INCREASED risk for CVD with HRT use. Prevention of osteoporosis is another reason; HRT does not fix osteoporosis, it just slows its progression. Osteoporosis starts decades earlier and does not suddenly start at menopause. Try less animal proteins, more fruits and veggies, soy products, high quality calcium supplements and exercise to reduce and maybe even reverse osteoporosis.

Ann Intern Med 2000;133:933-941,999-1001 Twenty years of prospective follow-up in the Nurses’ Health Study shows that daily estrogen doses of 0.625 mg or higher plus progestin may increase the risk of stroke by up to 45%. Dr. Grodstein’s group found that that the age-adjusted relative risk of a major coronary event was 0.54 for current users of hormone replacement therapy (HRT) compared with women who never used HRT. While they observed little overall difference in the relative risk of stroke among users and non-users of HRT, stroke risk varied by daily estrogen dose. Stroke risk was lower among women who received estrogen at 0.3 mg/d compared who those who took 0.625 or 1.25 mg/d. And among women taking 0.625 mg/d of estrogen combined with progestin, the authors observed a 45% higher risk of stroke compared with those who never took HRT. In an accompanying editorial, Drs. Deborah Grady and Stephen B. Hulley, of the University of California at San Francisco, sugg! est that “hormone therapy may have mixed effects, causing thrombotic events while improving the lipoprotein profile.” If that is the case, they speculate that prothrombotic activity may be more damaging to the small vessels of the cerebrovascular circulation than to the larger vessels of the coronary circulation.

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.







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