Stroke:口服避孕药、激素替代疗法和卒中风险

2022-06-25 MedSci原创 MedSci原创

口服避孕药和激素替代治疗与卒中风险增加相关,特别是在使用的第一年,可能是由于止血平衡的改变。

全世界有数百万女性使用外源性激素作为口服避孕药或激素替代疗法。然而,外源性激素对卒中风险的时间依赖性和长期影响尚未明确。

近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员分析了英国生物银行257194名生于1939年至1970年的女性,她们自述口服避孕药和激素替代疗法的使用与卒中风险之间的关系。该研究的结局包括任何类型的卒中、缺血性卒中、脑出血和蛛网膜下腔出血。在Cox回归模型中,研究人员将暴露量作为时变变量进行分析。

在口服避孕药使用的第一年,研究人员观察到受试者任何卒中事件发生率增加(风险比[HR]为2.49[95%CI为1.44-4.30]),而在口服避孕药使用的剩余年份,与未使用避孕药的患者相比,风险是相当的(风险比为1.00[95%CI为0.86-1.14])。

同样,激素替代疗法使用的第1年与任何卒中(风险比为2.12[95%CI为1.66-2.70])以及病因特异性卒中(包括缺血性卒中(风险比为1.93[95%CI为1.05-3.57])和蛛网膜下腔出血(风险比为2.17[95%CI为1.25-3.78])相关,在使用激素替代疗法的剩余年份(风险比为1.18[95%CI为1.05-1.31])和停用激素替代疗法后(风险比为1.16[95%CI为1.02-1.32])的风险都有所增加。

由此可见,口服避孕药和激素替代治疗与卒中风险增加相关,特别是在使用的第一年,可能是由于止血平衡的改变。这项研究为激素暴露对卒中风险的影响提供了新的见解,并提供了证据,不仅是总体风险,而且在治疗开始时观察到了明显的影响。

原始出处:

Therese Johansson.et al.Oral Contraceptives, Hormone Replacement Therapy, and Stroke Risk.stroke.2022.https://www.ahajournals.org/doi/10.1161/STROKEAHA.121.038659

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1742064, encodeId=8df61e4206473, content=<a href='/topic/show?id=3ba366833b2' target=_blank style='color:#2F92EE;'>#激素替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66833, encryptionId=3ba366833b2, topicName=激素替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8c7735017034, createdName=xinmeili, createdTime=Thu Nov 24 16:48:17 CST 2022, time=2022-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648385, encodeId=befa164838506, content=<a href='/topic/show?id=1b88603298d' target=_blank style='color:#2F92EE;'>#替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60329, encryptionId=1b88603298d, topicName=替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f1023558367, createdName=skhzy, createdTime=Tue Dec 27 09:48:17 CST 2022, time=2022-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281401, encodeId=5b171281401ca, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Mon Jun 27 00:48:17 CST 2022, time=2022-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582169, encodeId=cbb11582169e8, content=<a href='/topic/show?id=4fe43824210' target=_blank style='color:#2F92EE;'>#口服避孕药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38242, encryptionId=4fe43824210, topicName=口服避孕药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da1416890157, createdName=654699882_84926991, createdTime=Mon Jun 27 00:48:17 CST 2022, time=2022-06-27, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1742064, encodeId=8df61e4206473, content=<a href='/topic/show?id=3ba366833b2' target=_blank style='color:#2F92EE;'>#激素替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66833, encryptionId=3ba366833b2, topicName=激素替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8c7735017034, createdName=xinmeili, createdTime=Thu Nov 24 16:48:17 CST 2022, time=2022-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648385, encodeId=befa164838506, content=<a href='/topic/show?id=1b88603298d' target=_blank style='color:#2F92EE;'>#替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60329, encryptionId=1b88603298d, topicName=替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f1023558367, createdName=skhzy, createdTime=Tue Dec 27 09:48:17 CST 2022, time=2022-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281401, encodeId=5b171281401ca, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Mon Jun 27 00:48:17 CST 2022, time=2022-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582169, encodeId=cbb11582169e8, content=<a href='/topic/show?id=4fe43824210' target=_blank style='color:#2F92EE;'>#口服避孕药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38242, encryptionId=4fe43824210, topicName=口服避孕药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da1416890157, createdName=654699882_84926991, createdTime=Mon Jun 27 00:48:17 CST 2022, time=2022-06-27, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1742064, encodeId=8df61e4206473, content=<a href='/topic/show?id=3ba366833b2' target=_blank style='color:#2F92EE;'>#激素替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66833, encryptionId=3ba366833b2, topicName=激素替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8c7735017034, createdName=xinmeili, createdTime=Thu Nov 24 16:48:17 CST 2022, time=2022-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648385, encodeId=befa164838506, content=<a href='/topic/show?id=1b88603298d' target=_blank style='color:#2F92EE;'>#替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60329, encryptionId=1b88603298d, topicName=替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f1023558367, createdName=skhzy, createdTime=Tue Dec 27 09:48:17 CST 2022, time=2022-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281401, encodeId=5b171281401ca, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Mon Jun 27 00:48:17 CST 2022, time=2022-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582169, encodeId=cbb11582169e8, content=<a href='/topic/show?id=4fe43824210' target=_blank style='color:#2F92EE;'>#口服避孕药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38242, encryptionId=4fe43824210, topicName=口服避孕药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da1416890157, createdName=654699882_84926991, createdTime=Mon Jun 27 00:48:17 CST 2022, time=2022-06-27, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1742064, encodeId=8df61e4206473, content=<a href='/topic/show?id=3ba366833b2' target=_blank style='color:#2F92EE;'>#激素替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=66833, encryptionId=3ba366833b2, topicName=激素替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8c7735017034, createdName=xinmeili, createdTime=Thu Nov 24 16:48:17 CST 2022, time=2022-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1648385, encodeId=befa164838506, content=<a href='/topic/show?id=1b88603298d' target=_blank style='color:#2F92EE;'>#替代疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=60329, encryptionId=1b88603298d, topicName=替代疗法)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f1023558367, createdName=skhzy, createdTime=Tue Dec 27 09:48:17 CST 2022, time=2022-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281401, encodeId=5b171281401ca, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Mon Jun 27 00:48:17 CST 2022, time=2022-06-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582169, encodeId=cbb11582169e8, content=<a href='/topic/show?id=4fe43824210' target=_blank style='color:#2F92EE;'>#口服避孕药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38242, encryptionId=4fe43824210, topicName=口服避孕药)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=da1416890157, createdName=654699882_84926991, createdTime=Mon Jun 27 00:48:17 CST 2022, time=2022-06-27, status=1, ipAttribution=)]

相关资讯

Stroke:女性卒中结局

女性卒中患者往往有更好的协变量调整后的生存率,但女性幸存者的预后比男性患者更差,并持续到卒中后5年。

JAMA N:降低LDL-C,降低卒中风险

低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)水平升高是心血管疾病的危险因素,包括缺血性卒中。对于有缺血性卒中病史的患者,LDL-C水平升高与

JAHA:糖尿病、高血压、血脂异常、卒中或心肌梗死家族史与川崎病发病风险的关系

在这项全国性倾向评分匹配研究中,伴有心血管疾病家族史的患者与无心血管疾病家族史的患者相比,川崎病的发病风险显著增加。

tDCS联合步态平衡仪,在卒中后运动功能障碍康复中的应用

tDCS联合步态平衡仪,能改善脑卒中患者上肢运动功能,促进日常生活能力提升。

NEUROLOGY: MRI 上的卒中和腔隙计数是血管性认知障碍的独立预测因子

几乎一半的平均年龄为 50 岁的 CADASIL 患者存在 VCI。认知能力的下降体现在所有认知领域,包括记忆。MRI 上的卒中和腔隙计数都是 BMET  VCI 的独立预测因子。