Evidence map›Paper›PMID 25716175›Full record

Observational studyBMJ open2015

Statin use and risk of haemorrhagic stroke in a community-based cohort of postmenopausal women: an observational study from the Women's Health Initiative.

Elena Salmoirago-Blotcher, Kathleen M Hovey, Christopher A Andrews, Jennifer G Robinson, Karen C Johnson, Sylvia Wassertheil-Smoller, Sybil Crawford, Lihong Qi, Lisa W Martin, Judith Ockene and 1 more

Open access · goldAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 7 citations in OpenAlex.

  1. Are statin side effects dependent on sex? A narrative review.Przeglad menopauzalny = Menopause review · 2025
    Review
  2. Review
  3. Lipid Control and Beyond: Current and Future Indications for Statin Therapy in Stroke.Current treatment options in cardiovascular medicine · 2016
    Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 9 institutions in 1 country.

Elena Salmoirago-BlotcherCenters for Behavioral and Preventive Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.ORCID http://orcid.org/0000-0003-4636-8698
Kathleen M HoveyDepartment of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, USA.
Christopher A AndrewsDepartment of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, USA.
Jennifer G RobinsonDepartment of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA.
Karen C JohnsonDepartment of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee, USA.
Sylvia Wassertheil-SmollerDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
Sybil CrawfordDepartment of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Lihong QiDepartment of Public Health Sciences, One Shields Avenue, Med Sci 1-C, University of California, Davis, California, USA.
Lisa W MartinDivision of Cardiology, George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Judith OckeneDivision of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
JoAnn E MansonDivision of Preventive Medicine, Brigham and Women's Hospital & Harvard Medical School, Boston, Massachusetts, USA.
University at Buffalo, State University of New York · USUniversity of Massachusetts Chan Medical School · USAlbert Einstein College of Medicine · USBrigham and Women's Hospital · USBrown University · USGeorge Washington University · USUniversity of California, Davis · USUniversity of Iowa · USUniversity of Tennessee Health Science Center · US

Funding

Women's Health Initiative Memory Study (WHIMS)N01WH44221 · WH · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2009 to 2010
$3.1M
CLIN CTR CLIN TRIAL/OBSERVATIONAL STUDY OF WHIN01WH042119 · WH · YESHIVA UNIVERSITY · PI WASSERTHEIL-SMOLLER, SYLVIA · 1994 to 2001
$2.2M
VANGUARD CENTER FOR WOMEN'S HEALTH INITIATIVEN01WH032101 · WH · UNIVERSITY OF MINNESOTA TWIN CITIES · PI GRIMM, RICHARD H · 1993 to 2000
$1.7M
VANGUARD CENTER FOR WOMEN'S HEALTH INITIATIVEN01WH032111 · WH · EMORY UNIVERSITY · PI WATTS, NELSON · 1993 to 2001
$1.6M
CLIN CTR CLIN TRIAL/OBSERVATIONAL STUDY OF WHIN01WH042123 · WH · MEDSTAR RESEARCH INSTITUTE · PI HOWARD, BARBARA V · 1994 to 2000
$1.4M
CLIN CTR CLIN TRIAL/OBSERVATIONAL STUDY OF WHIN01WH042109 · WH · STANFORD UNIVERSITY · PI STEFANICK, MARCIA L · 1994 to 2000
$1.4M
CLIN CTR CLIN TRIAL/OBSERVATIONAL STUDY OF WHIN01WH042114 · WH · KAISER FOUNDATION RESEARCH INSTITUTE · PI RITENBAUGH, CHERYL K · 1994 to 2000
$1.4M
CLIN CTR CLIN TRIAL/OBSERVATIONAL STUDY OF WHIN01WH042108 · WH · GEORGE WASHINGTON UNIVERSITY · PI HSIA, JUDITH · 1994 to 2000
$1.4M
CLIN CTR CLIN TRIAL/OBSERVATIONAL STUDY OF WHIN01WH042124 · WH · RUSH UNIVERSITY MEDICAL CENTER · PI BLACK, HENRY R · 1994 to 2000
$1.4M
CLIN CTR CLIN TRIAL/OBSERVATIONAL STUDY OF WHIN01WH042131 · WH · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI O'SULLIVAN, MARY J · 1994 to 2000
$1.3M
WOMENS HEALTH INITIATIVE-N01WH22110N01WH022110 · WH · FRED HUTCHINSON CANCER RESEARCH CENTER · PI ROSS, PRENTICE · 1992 to 2006
$1.2M
VANGUARD CENTER FOR WOMEN'S HEALTH INITIATIVEN01WH032105 · WH · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI LEWIS, CORA E · 1993 to 2000
$1.2M
WHI NIH HHS N01 WH022110WHI NIH HHS N01WH24152WHI NIH HHS N01WH32100WHI NIH HHS N01WH32101WHI NIH HHS N01WH32102WHI NIH HHS N01WH32105WHI NIH HHS N01WH32106WHI NIH HHS N01WH32108WHI NIH HHS N01WH32109WHI NIH HHS N01WH32111WHI NIH HHS N01WH32112WHI NIH HHS N01WH32113WHI NIH HHS N01WH32115WHI NIH HHS N01WH32118WHI NIH HHS N01WH32119WHI NIH HHS N01WH32122WHI NIH HHS N01WH42107WHI NIH HHS N01WH42108WHI NIH HHS N01WH42109WHI NIH HHS N01WH42110WHI NIH HHS N01WH42111WHI NIH HHS N01WH42112WHI NIH HHS N01WH42113WHI NIH HHS N01WH42114WHI NIH HHS N01WH42115WHI NIH HHS N01WH42116WHI NIH HHS N01WH42117WHI NIH HHS N01WH42118WHI NIH HHS N01WH42119WHI NIH HHS N01WH42120WHI NIH HHS N01WH42121WHI NIH HHS N01WH42122WHI NIH HHS N01WH42123WHI NIH HHS N01WH42124WHI NIH HHS N01WH42125WHI NIH HHS N01WH42126WHI NIH HHS N01WH42129WHI NIH HHS N01WH42130WHI NIH HHS N01WH42131WHI NIH HHS N01WH42132WHI NIH HHS N01WH44221
6 · The paper itself

Abstract

objectivesTo determine whether statin treatment is associated with increased risk of haemorrhagic stroke (HS) in older women. A secondary objective was to evaluate HS risk in users of combined statin and antiplatelet treatment.

designObservational study: secondary data analysis from the Women's Health Initiative (WHI) clinical trials.

settingWomen were recruited from 40 participating sites.

participantsCohort of 68,132 women followed through 2005 (parent study) and for an additional 5 years in the extension study.

main outcome measuresStatin use was assessed at baseline and at follow-up visits (1, 3, 6 and 9 years). Women brought medications in original containers for inventory. Strokes were ascertained semiannually and centrally adjudicated. Risk of HS by statin use (time-varying covariate, with the 'no use' category as the referent) was estimated from Cox proportional hazard regression models adjusted for age (model 1); risk factors for HS (model 2); and possible confounders by indication (model 3). Prespecified subgroup analyses were conducted by use of antiplatelet medications.

resultsFinal models included 67,882 women (mean age, 63±7 years). Over a mean follow-up of 12 years, incidence rates of HS were 6.4/10,000 person-years among statin users and 5.0/10,000 person-years among non-users (p=0.11). The unadjusted risk of HS in statin users was 1.21 (CI 0.96 to 1.53); after adjusting for age and HS risk factors the HR was 0.98 (CI 0.76 to 1.26). Risk of HS was higher among women on statins and antiplatelet agents versus women on antiplatelet medications alone (HR=1.59; CI 1.03 to 2.47); p for interaction=0.011.

conclusionsThis retrospective analysis did not show an association between statin use and HS risk among older women. HS risk was higher among women taking statins with antiplatelet agents. These findings warrant further investigation, given potential implications for clinical decision-making.

Indexed as

Women's HealthFemaleFollow-Up StudiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMiddle AgedPostmenopauseProportional Hazards ModelsRetrospective StudiesRisk FactorsStrokeHydroxymethylglutaryl-CoA Reductase InhibitorsPREVENTIVE MEDICINE

Identifiers

PMID25716175
PMCPMC4342587
OpenAlexW2096129197

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.