Hormone Replacement Therapy Users with Worsening Migraine Headaches May be at Increased Risk for Ischemic Stroke

A large observational study presented at the 2016 International Stroke Conference suggests women who are receiving hormone replacement therapy (HRT) and are experiencing increasingly severe migraine headaches, are at an increased risk for ischemic stroke. Ischemic stroke results from an obstruction within a blood vessel supplying blood to the brain and accounts for 87 percent of all strokes, Medscape Medical News reports.

The lead investigator, Dr. Rahman, presented the study at the conference and said this new analysis is the first to examine whether changes in migraine severity, with HRT use, are an ischemic stroke risk.

Data from the Women’s Health Initiative for 82,208 women aged 50-79 years old, who had migraines at baseline was analyzed by researchers. Of these subjects, 37,680 were current HRT users, which included unopposed estrogen and/or estrogen with progesterone use, and 44,528 were former HRT users or women had never taken HRT, according to Medscape Medical News.

In the course of 12 years of follow-up, 2,063 women suffered an ischemic stroke. The rate of increase in headache severity was significantly higher in current HRT users, compared to never and past HRT users. The “real significant finding” was current HRT users who experienced an increase in migraine severity had a 30 percent increase in ischemic stroke risk, Medscape Medical News reports.

Study results were adjusted for known stroke risk factors including age, hypertension, hypercholesterolemia, diabetes, and smoking. According to Dr. Silver, director of the Stroke Center of Rhode Island Hospital, when an older patient is taking HRT, “there’s always some concerns amongst stroke neurologists, and if migraines are increasing while on hormone therapy, an alternative treatment may be a consideration.

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