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Millions of women use exogenous hormones as hormone replacement therapy (HRT) or oral contraceptives (OC). Still, time-dependent and long-term consequences of exogenous hormones on cerebrovascular health remains unclear.

We examined the effects of HRT and OC usage on stroke risk in 256,661 women from UK Biobank, born between 1939 and 1970. Outcomes included any type of stroke, ischemic stroke (IS), intracerebral hemorrhage (IH), and subarachnoid hemorrhage (SH). Exposures were analyzed as time-dependent variables in Cox regression models. Results are expressed as hazard ratios (HR) with 95% confidence intervals.

During first year of exposure, HRT usage was associated with higher hazard rates of any stroke (HR = 2.12[1.66-2.70]), IS (HR = 1.93[1.04-3.56]) and SH (HR = 2.14[1.23-3.72]) compared to non-usage, which remained significant only …