Stroke findings in the women's health initiative

Sylvia Wassertheil-Smoller, Robert C. Kaplan, Christian R. Salazar

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

The Women's Health Initiative (WHI) clinical trials of estrogen with or without progestin versus placebo in 27,341 postmenopausal women are the largest randomized, placebo-controlled, double-blind clinical trials to look at the effect of hormone therapy on the outcomes of stroke, dementia, and cognition. Data from a parallel prospective observational study of 93,676 women examine biomarkers and risk factors associated with stroke. We summarize the results of 29 published articles in the WHI with stroke or cognition as outcomes of interest. Estrogen alone or in combination with progestin resulted in approximately 50% excess risk of ischemic stroke and in a 76% excess risk of dementia in women 65 years or older. Other risk factors for stroke identified in the WHI were panic attacks, depression, use of antidepressants (particularly selective serotonin reuptake inhibitors for hemorrhagic but not ischemic stroke), high triglycerides, low walking speed, long sleep duration, certain inflammatory factors, and systolic blood pressure variability. Hormone therapy has adverse effects on the brain as manifested by higher risks of stroke and dementia. Additional risk factors for stroke identified in WHI should be followed up to determine if reversing them would result in lower stroke rates.

Original languageEnglish (US)
Pages (from-to)438-446
Number of pages9
JournalSeminars in Reproductive Medicine
Volume32
Issue number6
DOIs
StatePublished - 2014

Fingerprint

Women's Health
Stroke
Dementia
Progestins
Cognition
Estrogens
Placebos
Clinical Trials
Hormones
Blood Pressure
Panic Disorder
Serotonin Uptake Inhibitors
Antidepressive Agents
Observational Studies
Sleep
Triglycerides
Biomarkers
Prospective Studies
Depression
Brain

Keywords

  • dementia
  • hormone therapy
  • postmenopausal women
  • stroke
  • WHI
  • Women's Health Initiative

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Physiology (medical)
  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Medicine(all)

Cite this

Stroke findings in the women's health initiative. / Wassertheil-Smoller, Sylvia; Kaplan, Robert C.; Salazar, Christian R.

In: Seminars in Reproductive Medicine, Vol. 32, No. 6, 2014, p. 438-446.

Research output: Contribution to journalArticle

Wassertheil-Smoller, Sylvia ; Kaplan, Robert C. ; Salazar, Christian R. / Stroke findings in the women's health initiative. In: Seminars in Reproductive Medicine. 2014 ; Vol. 32, No. 6. pp. 438-446.
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