Hormone replacement therapy (HRT) is associated with an increased risk of severe stroke, according to a new review of previous studies on the issue.

The results of individual trials have produced inconsistent results, explain Drs. Philip M. W. Bath and Laura J. Gray of the University of Nottingham, UK, in the British Medical Journal. Their goal therefore was to systematically review evidence from completed clinical trials analyzing the relationship between stroke and HRT.

The team identified 28 trials that included nearly 40,000 women whose average age ranged from 55 to 71 years. The subjects were followed for about 1 to 7 years.

The pooled data showed that, overall, the women who used hormone replacement had a 29 percent higher risk of stroke than those in comparison groups.

“Importantly, the severity of stroke was increased with hormone replacement therapy, since the frequency of a poor functional outcome, judged as combined death and disability or dependency, was 56 percent higher in those randomised to therapy,” Bath and Gray add.

The researchers recommend that “patients at high risk of stroke - such as those with previous stroke, coronary heart disease, or multiple vascular risk factors - should stop taking hormone replacement therapy unless there is a strong contrary medical reason.”

SOURCE: British Medical Journal, online January 6, 2005.