Oral Contraceptives, Hormone Replacement Therapy, and Stroke Risk

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Johansson, ThereseUppsala universitet,WoMHeR (Centre for Women’s Mental Health during the Reproductive Lifespan),Science for Life Laboratory, SciLifeLab,Genomik och neurobiologi (author)

Oral Contraceptives, Hormone Replacement Therapy, and Stroke Risk

Article/chapterEnglish2022

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Lippincott Williams & Wilkins,2022
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LIBRIS-ID:oai:DiVA.org:uu-482558
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-482558URI
https://doi.org/10.1161/strokeaha.121.038659DOI

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Language:English
Summary in:English

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De två sista författarna delar sistaförfattarskapet.
BACKGROUND: Millions of women worldwide use exogenous hormones as oral contraceptives or hormone replacement therapy. Still, time-dependent and long-term consequences of exogenous hormones on stroke risk remains unclear.METHODS: We examined the association between self-reported oral contraceptive and hormone replacement therapy use and stroke risk in 257 194 women from the UK Biobank, born between 1939 and 1970. Outcomes included any type of stroke, ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Exposures were analyzed as time-varying variables in Cox regression models.RESULTS: During first year of oral contraceptive use, an increased event rate of any stroke was observed (hazard ratio [HR], 2.49 [95% CI, 1.44-4.30]), while the hazards were found to be comparable during remaining years of use (HR, 1.00 [95% CI, 0.86-1.14]), compared with nonusers. Similarly, first year of hormone replacement therapy use was associated with higher hazard rates of any stroke (HR, 2.12 [95% CI, 1.66-2.70]), as well as cause-specific stroke, including ischemic stroke (HR, 1.93 [95% CI, 1.05-3.57]) and subarachnoid hemorrhage (HR, 2.17 [95% CI, 1.25-3.78]), which remained increased for any stroke during remaining years of use (HR, 1.18 [95% CI, 1.05-1.31]), and after discontinuation (HR, 1.16 [95% CI, 1.02-1.32]).CONCLUSIONS: Oral contraceptive use and hormone replacement therapy were associated with an increased risk of stroke, especially during the first year of use, possibly due to immediate changes in hemostatic balance. This study provides new insights on the effects of hormone exposure on stroke risk and provide evidence of not only an overall risk but also a pronounced effects seen in the beginning of treatment.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Medicinska och farmaceutiska grundvetenskaper Farmakologi och toxikologi hsv//swe
MEDICAL AND HEALTH SCIENCES Basic Medicine Pharmacology and Toxicology hsv//eng
Epidemiologi
Epidemiology

Added entries (persons, corporate bodies, meetings, titles ...)

Fowler, PhilipUppsala universitet,Statistiska institutionen(Swepub:uu)phifo969 (author)
Ek, Weronica E.Uppsala universitet,Science for Life Laboratory, SciLifeLab,Genomik och neurobiologi(Swepub:uu)werek336 (author)
Skalkidou, Alkistis,1977-Uppsala universitet,Obstetrisk och reproduktiv hälsoforskning(Swepub:uu)alksk607 (author)
Karlsson, TorgnyUppsala universitet,Genomik och neurobiologi,Science for Life Laboratory, SciLifeLab(Swepub:uu)tka28508 (author)
Johansson, ÅsaUppsala universitet,Science for Life Laboratory, SciLifeLab,Genomik och neurobiologi(Swepub:uu)asjoh108 (author)
Uppsala universitetWoMHeR (Centre for Women’s Mental Health during the Reproductive Lifespan) (creator_code:org_t)

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In:Stroke: Lippincott Williams & Wilkins53:10, s. 3107-31150039-24991524-4628

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By the author/editor: Johansson, There ...; Fowler, Philip; Ek, Weronica E.; Skalkidou, Alkis ...; Karlsson, Torgny; Johansson, Åsa

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