Hormone replacement therapy and risk of subarachnoid hemorrhage in postmenopausal women
Adnam I. Quereshi, Ahemed A. Malik, Omar Saeed, et al. (JNS)
In this paper they analyzed 93,676 women between 50-79 years old. They studied the effect of hormone replacement therapy (HRT) on the risk of subarachnoid hemorrhage (SAH) through 12 years. Also they identified the risk associated with “estrogen only” and “estrogen and progesterone together” as HRT. Only 114 (0,1%) participants developed SAH during the follow up period. The absolute difference among women on active HRT (0.14%) compared to those without HRT use (0.11%) was 0,03%. When the analysis is unadjusted for age, systolic blood pressure, cigarette smoking, alcohol consumption, body mass index, race/ethnicity, diabetes and cardiovascular disease the risk of SAH were 60% more likely woman on active use of HRT after adjusting to be higher. Mainly the combination of cigarette smoking and oral contraceptive use resulted in a synergistic increase of the risk. There is no any difference between uses ”estrogen and progesterone”, both were associated with an increased risk of SAH. Presence of unruptured aneurysms, family history, or cardiovascular risk factors were identify as risk for SAH. Postmenopausal women with those conditions should be counseled against use HRT.
Abstract link: http://www.ncbi.nlm.nih.gov/pubmed/26162033