stroke and HRT
Last reviewed 01/2018
In the Women's Health Initiative study there was a relative risk 1.41 at 5.2 years of the development of a stroke (comparing oestrogen plus progestogen arm vs. placebo group) (1) - this meant an increased absolute risk of 8 per 10,000 women per year.
NICE state with respect risk of stroke with HRT (2):
Explain to women that taking oral (but not transdermal) oestrogen is associated with a small increase in the risk of stroke
- the baseline population risk of stroke in women aged under 60 years is
very low
- Table: Absolute rates of stroke for different types of HRT compared with no HRT (or placebo), different durations of HRT use and time since stopping HRT for menopausal women
- difference in stroke incidence per 1000 menopausal women over 7.5 years (95% confifidence interval) (baseline population risk in the UK over 7.5 years: 11.3 per 1000
| Current HRT users | Treatment duration <5 years | Treatment duration 5-10 years | >5 years since stopping treatment | ||
| Women on oestrogen alone | RCT estimate | 0 (-5 to 10) | No available data | No available data | 1 more (-4 to 9) |
| Women on oestrogen alone | Observational estimate | 3 more (-1 to 8) | No available data | No available data | No available data |
| Women on oestrogen + progestogen | RCT estimate | 6 more (-2 to 21) | No available data | No available data | 4 more (-1 to 13) |
| Women on oestrogen + progestogen | Observational estimate | 4 more (1 to 7) | No available data | No available data | No available data |
Reference: