Stroke risks fade when women stop taking estrogen, study finds

By H. Darr Beiser, USA TODAY

Many menopausal women take estrogen pills; many also fear its effects.

EnlargeCloseBy H. Darr Beiser, USA TODAY

Many menopausal women take estrogen pills; many also fear its effects.

The latest study bolsters previous evidence that concerns about breast cancer and heart attacks are largely unfounded for those who take the hormone for a short period of time to relieve hot flashes and other menopause symptoms.

Estrogen-only pills are recommended just for women who have had a hysterectomy, and the study focused only on that group. About 25% of women in menopause have had hysterectomies. Other women are prescribed a combination pill of estrogen and progestin because for them, estrogen alone can raise the risk for cancer of the uterus.

The study results don't really change the advice doctors have been giving for several years now: Take hormones to relieve menopause symptoms in the lowest possible dose for the shortest possible time.

The women in the study took estrogen for about six years and were evaluated for about four years after stopping. Slightly increased risks for strokes and blood clots that were found while they took the pills disappeared during the follow-up. Unfortunately, the bone-strengthening benefit of estrogen disappeared, too. Once women ended it, they had just as many hip fractures during the follow-up as women who'd taken dummy pills.

The research also found that women who started taking estrogen-only pills in their 50s fared better after stopping than women who'd started in their 70s

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New heart valve holds promise and stroke risk

but as many as 30% of patients are too sick, or unwilling, to risk an operation than involves cracking open the breastbone, stopping the heart and putting patients on a heart-lung machine, said Ralph Brindis, president of the American College of Cardiology.

In the procedure, the new valve made of cow tissue encased in a springlike stent is guided into the heart and slipped into place in the heart by inflating a small balloon. The valve, made by the study's sponsor, Edwards Lifesciences, is awaiting approval by the Food and Drug Administration.

Half the patients in the new study got the experimental valve, and the rest underwent standard valve surgery, Smith reported at the annual scientific meeting of the American College of Cardiology here.

Death rates were similar, 24% for the new procedure and 27% for surgery, he said. Twenty patients who got the new valve suffered strokes, compared with 10 patients in the surgery group.

Some doctors said the stroke risk would deter many patients. "Some people say they'd rather be dead than live with a stroke," said Rita Redberg of the University of California-San Francisco.

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