Tuomikoski Pauliina, Lyytinen Heli, Korhonen Pasi, Hoti Fabian, Vattulainen Pia, Gissler Mika, Ylikorkala Olavi, Mikkola Tomi S
Department of Obstetrics and Gynecology, Helsinki University Hospital, PO Box 140, , 00029 HUS Helsinki, Finland.
EPID Research Oy, Metsänneidonkuja 12, 02130 Espoo, Finland.
Maturitas. 2015 Jul;81(3):384-8. doi: 10.1016/j.maturitas.2015.04.002. Epub 2015 Apr 13.
The Women's Health Initiative (WHI) study clarified the indications and contraindications for postmenopausal hormone therapy (HT). We studied the impact of the WHI results on the risk of fatal stroke in HT users in Finland.
Retrospective analysis setting: Nationwide registers on postmenopausal HT use and causes of death between 1995 and 2009.
Women ≥40 years (n=290,272) using systemic estradiol-based postmenopausal HT.
Follow-up started from the first HT purchase during the pre-WHI era (1995-2001) and post-WHI era (2002-2009).
Stroke deaths in HT users were compared with that in the age-matched background population and expressed as standardized mortality ratio (SMR) with 95% confidence intervals.
Overall, 311 HT users died due to stroke. The exposure to HT ≤1 year was associated with a similarly reduced 22% (0.67-0.91) risk of stroke death in the pre-WHI era and in the post-WHI era 27% (0.55-0.94). The risk reductions for HT exposure of 1-8 years in the pre-WHI era (47%, 0.42-0.65) did not differ from that in the post-WHI era (32%, 0.48-0.94). The discontinuation of HT was accompanied by a significant 33% (1.02-1.72) increase in stroke death risk in the pre-WHI era and a non-significant 32% (0.84-1.99) increase in the post-WHI era within the first post-treatment year, but no longer after 1-8 years.
The change in prescribing policy after the WHI study did not affect the risk of fatal stroke in Finnish HT users.
女性健康倡议（WHI）研究明确了绝经后激素治疗（HT）的适应证和禁忌证。我们研究了WHI结果对芬兰HT使用者致命性卒中风险的影响。
回顾性分析
1995年至2009年间全国范围内关于绝经后HT使用情况及死亡原因的登记资料。
年龄≥40岁（n = 290,272）且使用基于雌二醇的系统性绝经后HT的女性。
随访从WHI研究前时代（1995 - 2001年）和WHI研究后时代（2002 - 2009年）首次购买HT开始。
将HT使用者的卒中死亡情况与年龄匹配的背景人群进行比较，并以标准化死亡比（SMR）及95%置信区间表示。
总体而言，311名HT使用者死于卒中。在WHI研究前时代和研究后时代，使用HT≤1年与卒中死亡风险同样降低相关，分别降低22%（0.67 - 0.91）和27%（0.55 - 0.94）。在WHI研究前时代，使用HT 1 - 8年的风险降低（47%，0.42 - 0.65）与研究后时代（32%，0.4
