Oral contraceptives, menopause hormone replacement therapy, and risk of stroke.
OBJECTIVE
To review available evidence from observational and intervention studies on oral contraceptives (OC), menopause hormone replacement therapy (HRT) and stroke.


METHODS
Qualitative literature review.


RESULTS
High dose OC were associated to elevated risk of stroke. However, the use of low oestrogen OC preparations by non-hypertensive women not at high baseline risk is not related to an appreciable risk of stroke. With reference to HRT, randomised clinical trials showed an excess risk of stroke among users of combined therapy.


CONCLUSIONS
In non-hypertensive women below age 35 stroke is not materially related to the use of low dose OC. HRT is associated to a moderate excess risk in randomised studies, and should therefore not be used for the prevention of stroke.
La Vecchia
Carlo
C
Istituto di Ricerche Farmacologische "Mario Negri", Milano, Italy. bonifacino@marionegri.it
D003277:Contraceptives, Oral, Combined / Q000009:adverse effects*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*
D003277:Contraceptives, Oral, Combined