Hormone replacement therapy and ischemic stroke severity in women: a case-control study

Area of Science:

• Neurology
• Cardiovascular Medicine
• Endocrinology

Background:

• Estrogen demonstrates neuroprotective properties in animal models of ischemic stroke.
• Limited human data exist regarding the impact of hormone replacement therapy (HRT) on ischemic stroke severity.

Purpose of the Study:

• To determine if ischemic stroke severity differs between women using HRT and those not using HRT.
• To investigate the potential neuroprotective effects of HRT in human ischemic stroke patients.

Main Methods:

• Retrospective review of 58 women receiving HRT at admission for acute ischemic stroke.
• Matching HRT users with 116 nonusers based on age and stroke risk factors.
• Assessment of stroke severity using the Canadian Neurological Scale, analyzed with nonparametric tests and regression modeling.

Main Results:

• Univariate analysis identified congestive heart failure, coronary artery disease, atrial fibrillation, and African American race as associated with greater stroke severity.
• A trend towards lesser stroke severity was observed in HRT users (median Canadian Neurological Scale score 10 vs. 9.5), but this was not statistically significant (p=0.08).
• Multivariate analysis revealed no independent effect of HRT use on stroke severity (p=0.17).

Conclusions:

• Hormone replacement therapy status did not significantly impact ischemic stroke severity in this cohort.
• The retrospective nature of this study necessitates prospective research to further clarify any potential neuroprotective role of HRT in stroke.