Meta-analysis of the Association of Menopausal Hormone Therapy with Stroke

doi:10.3969/j.issn.1673-5765.2022.09.008

Abstract

Abstract: Objective To evaluate the association between menopausal hormone therapy and stroke.
Methods The PubMed, Embase and Cochrane Library were retrieved for randomized controlled trials (RCTs) and observational studies on menopause hormone therapy for postmenopausal women published from inception to January 5, 2022. The treatment in RCTs must be oral hormone therapy, and the follow-up time should be over 6 months. The outcome was the incidence of stroke in the subjects of the included studies. The association between menopausal hormone therapy and stroke was analyzed.
Results The meta-analysis of RCTs included 7 studies including 35 776 healthy women, and stroke occurred in 566 women (1.58%). Of 18 337 healthy women who received menopausal hormone therapy, stroke occurred in 332 women (1.81%). In the control group, stroke occurred in 234 (1.34%) among 17 439 healthy women. The incidence of stroke in healthy women who received menopausal hormone therapy was 1.40 times higher than that in those who did not receive menopausal hormone therapy (RR 1.40, 95%CI 1.19-1.65). The meta-analysis of observational studies on menopausal hormone therapy showed that 1425 (0.84%) stroke occurred in 167 770 women from 3 studies. Stroke occurred in 513 (0.84%) of 61 117 women receiving menopausal hormone therapy and 912 (0.86%) of 106 653 women in the control group, and there was no statistical difference in the incidence of stroke between the menopausal hormone treatment group and the control group (RR 0.96, 95%CI 0.86-1.07).
Conclusions There may be no significant association between menopausal hormone therapy and stroke.

Key words: Woman; Menopausal hormone therapy; Stroke; Meta-analysis

摘要： 目的评估绝经激素治疗与卒中发生之间的相关性。
方法计算机检索PubMed、Embase和Cochrane图书馆从建库到2022年1月5日已经发表的关于绝经后女性采取绝经激素治疗的随机对照试验以及观察性研究，其中随机对照试验治疗方式必须为口服激素治疗，且随访的时间应超过6个月。探索绝经激素治疗与卒中之间的相关性，结局指标为研究人群的卒中发生率。
结果绝经激素治疗随机对照试验的meta分析纳入了7项研究，35 776例健康女性中共有566例（1.58%）发生卒中，接受绝经激素治疗的18 337例健康女性中共有332例（1.81%）发生卒中，对照组17 439例中共有234例（1.34%）发生卒中，绝经激素治疗的健康女性卒中发病率是对照组的1.40倍（RR 1.40，95%CI 1.19～1.65）。绝经激素治疗观察性研究的meta分析纳入了3项研究，167 770例女性中共有1425例（0.84%）发生卒中，接受绝经激素治疗的61 117例女性中共有513例（0.84%）发生卒中，对照组106 653例女性中共有912例（0.86%）发生卒中，绝经激素治疗组与对照组之间差异无统计学意义（RR 0.96，95%CI 0.86～1.07）。
结论绝经激素治疗与卒中发生之间可能无明显的相关性。

关键词: 女性; 绝经激素治疗; 卒中; meta分析

CAO Yuting, FAN Wenjuan, WANG Chunxue, CHEN Ying. Meta-analysis of the Association of Menopausal Hormone Therapy with Stroke [J]. Chinese Journal of Stroke, 2022, 17(09): 957-965.

曹雨停, 范文娟, 王春雪, 陈瑛. 绝经激素治疗与卒中相关性的meta分析 [J]. 中国卒中杂志, 2022, 17(09): 957-965.

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