Early Risk of Cardiac, Stroke Deaths Up after Women Stop Hormone Therapy

By Rob Goodier

NEW YORK - Women who stop postmenopausal hormone therapy (HT) are at increased risk of cardiac and stroke death in the first year following discontinuation, but the risks drop below what would be expected after more than one year, a new study shows.

"In healthy, recently menopausal women with symptoms, HT may be used at least until the age of 60 without discontinuation, because in addition to the symptom relief, (patients) receive cardiovascular benefit from the treatment," lead author Dr. Tomi Mikkola from Helsinki University in Finland told Reuters Health by email.

"In other words, the benefits outweigh the risks and therefore there is no need to discontinue HT each year," as many do, he said.

The study, online September 28 in the Journal of Clinical Endocrinology & Metabolism, used national register data on more than 330,000 women in Finland who discontinued HT between 1994 and 2009. The women were followed until cardiac or stroke death, or until the end of 2009.

Compared with the expected number of deaths in the age-standardized background population, the risk of cardiac death was significantly increased in the first year post-treatment (standardized mortality ratio, 1.26). At follow-up of more than one year, however, it was significantly reduced (SMR, 0.75). For stroke deaths, the numbers were 1.63 and 0.89, respectively.

The greatest risk of cardiac death was seen in women who stopped therapy when they were younger than 60 and had been on it for more than five years (SMR, 2.54). Those women also had a significantly higher risk of stroke (SMR, 3.29).

"Obviously individualized treatment is the key," Dr. Mikkola said, noting that "all risk factors should be carefully considered with each woman initiating HT."

SOURCE: https://bit.ly/1jfp58w

J Clin Endocrinol Metab 2015.

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