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      Hormone replacement therapy and stroke: clinical trials review.

      1
      Stroke
      Ovid Technologies (Wolters Kluwer Health)

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          Abstract

          Bench research suggests that postmenopausal hormonal therapy is associated with beneficial effects on the brain and vascular system. Observational data suggest that postmenopausal hormone replacement therapy is associated with a 25% to 50% lower rate of cardiovascular disease; however, observational data for hormonal therapy is associated with the potential for significant biases. Clinical trial data are needed. There are 3 major clinical trials that inform us about stroke and postmenopausal hormone replacement therapy. Two trials focused on secondary prevention: the Heart and Estrogen/progesterone Replacement Study (HERS) and the Women's Estrogen for Stroke Trial (WEST). One examined primary prevention: the Women's Health Initiative (WHI). All indicate that postmenopausal hormone therapy is not effective for reducing the risk of a recurrent stroke or death among women with established vascular disease or for prevention of a first stroke. Similar results exist for cardiovascular disease. The results of these trials are now reflected in national guidelines. Hormone therapy should not be initiated to prevent vascular disease among postmenopausal women. As a result of these trials, the portion of postmenopausal women using hormone replacement therapy in the United States has fallen by more than half over the past decade.

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          Author and article information

          Journal
          Stroke
          Stroke
          Ovid Technologies (Wolters Kluwer Health)
          1524-4628
          0039-2499
          Nov 2004
          : 35
          : 11 Suppl 1
          Affiliations
          [1 ] Department of Neurology, LCI-700, Yale University School of Medicine, PO Box 208018, 15 York Street, New Haven, CT 06520-8018, USA. lawrence.brass@yale.edu
          Article
          01.STR.0000143218.20061.ac
          10.1161/01.STR.0000143218.20061.ac
          15459443
          b0d6509d-5e5e-458d-a42a-2f54185cc513
          History

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