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BMJ 2005;330:345 (12 February), doi:10.1136/bmj.330.7487.345
Fay Crawford, NHS R&D fellow1, Peter Langhorne, professor of stroke care2
1 Tayside Centre for General Practice, MacKenzie Building, Dundee DD2 4BF, 2 Academic Department for Geriatric Medicine, Glasgow Royal Infirmary, Glasgow G31 2ER
Correspondence to: F Crawford f.crawford@chs.dundee.ac.uk
| The first 150 words of the full text of this article appear below. |
The meta-analysis by Bath and Gray provides evidence that hormone replacement therapy does not confer any protection against stroke in postmenopausal women but increases their risk of stroke.1 These observations add to a rapidly expanding literature on the potential hazards and benefits of the therapy.2
The women's health initiative trial contributes well over half of the current trial data, and its findings dominate the meta-analysis. The women's health initiative trial sought to assess the risks and benefits of three separate interventionsa low fat diet, hormone replacement therapy, and calcium supplementsin 64 500 women over a 15 year period.3 Two separate types of hormone replacement therapy were tested, monotherapy (oestrogen alone) and dual therapy (oestrogen plus progesterone), in two separate trial arms recruiting a total of 27 000 women.
In the dual therapy arm of the trial (n = 16 608) an increased risk of stroke became apparent by the second
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