Stroke Hormones and Outcomes in Women (SHOW) Study: Is the ‘Healthy-User Effect’ Valid for Women after Stroke?

Aims: To determine differences in stroke severity and outcomes in women using hormone therapy (HT) versus nonusers at baseline, and to investigate whether there is a ‘healthy-user effect’ of HT in women with stroke. Materials and methods: A total of 133 women over the age of 18 years with acute ischemic stroke were enrolled and categorized based on their use of HT at the time of stroke. Initial stroke severity was assessed at admission, and disability and activities of daily living were assessed at 6-month intervals for 2 years. Results: A total of 30% of the cohort were HT users. HT users were less likely to have hypertension and were leaner than nonusers. There were no differences in initial stroke severity, mortality or any of the functional status outcomes based on HT use at baseline. Conclusion: There did appear to be a healthy-user effect for HT users at baseline, but following stroke, there were no significant differences in long-term outcomes.