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Hot flashes may be marker of CVD risk
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20th Annual North American Menopause Society Meeting
Hot flashes may be associated with increased carotid intima-media thickness — a finding that further supports rising literature linking hot flashes with cardiovascular disease, according to data from the SWAN Heart study, presented at the North American Menopause Society 20th Annual Meeting.
A companion study published in Circulation in March 2008 showed that women who reported hot flashes also had poor endothelial function and more calcified plaque in the aorta, according to senior author Karen A. Matthews, PhD, distinguished professor of psychiatry at the University of Pittsburgh. “[These two reports reveal that] women who report hot flashes when they are pre-CVD are more likely to have early markers of subclinical CVD,” Matthews told Endocrine Today.
The researchers evaluated 411 women from the Study of Women’s Health Across the Nation (SWAN) Heart Study. All women had an intact uterus and ovaries, and none had CVD at baseline. At both baseline and a follow-up visit an average of two years later, participants completed interviews for hot flashes, health behaviors, bleeding patterns, medication use and health status; blood sampling of lipids, glucose and estradiol; measurements of height, weight and blood pressure; and ultrasound assessment of carotid intima-media thickness.
Multivariable models revealed hot flashes were related to concurrently assessed intima-media thickness at both baseline (P=.05) and follow-up (P=.02). Women who reported having hot flashes at baseline and at follow-up had increased intima-media thickness compared with women who reported not having hot flashes at either visit (P=.02).
These associations remained after the researchers adjusted for serum estradiol concentrations. They did not find any interactions between hot flashes and age, hormone therapy use or menopausal status in relation to intima-media thickness.
“It’s too early to say why this is occurring and what the interventions should be, but these data do suggest that in women having lots of hot flashes, clinicans should look very carefully at their cardiovascular risk factor levels, in particular the lipids, the lifestyle and their inflammatory levels,” Matthews said. - by Tina DiMarcantonio
Women who have significant hot flashes appear to be different than women who do not have them. This study and other similar studies which have found increased plaque deposits suggest that women with symptomatic hot flashes may have more CV risk factors. More research is needed to explain the link between hot flashes and underlying CV changes. Clinicians should evaluate these women with lipid profiles, cardiac inflammatory levels and encourage reduction in CV risk through diet, exercise and, when needed, medication.
– JoAnn V. Pinkerton, MD
Professor, Obstetrics and Gynecology
Director, Midlife Health Center and Division, University of Virginia
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