cardiovascular disease

Menopause: Hot Flashes Tied to Later CVD Risk

Frequent menopausal vasomotor symptoms (VMS), especially when persistent, are likely tied to an increased risk of cardiovascular disease (CVD) events later in life, according to research being presented at the North American Menopause Society’s 2019 Annual Meeting in Chicago, Illinois.1 The new findings serve as the “strongest evidence, to date” of the relationship between VMS and clinical CVD.2

Researchers arrived at this conclusion after evaluating data on 3302 pre-menopausal or early perimenopausal women aged 42 to 52 years who were enrolled in the Study of Women’s Health Across the Nation (SWAN). Inclusion criteria for the present study were having a uterus, having at least 1 ovary, and no treatment with hormone therapy (HT). Follow-up lasted 20 years.

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Frequency of VMS, including hot flashes and night sweats, were assessed annually via questionnaire (none, 1 to 5 days, or at least 6 days, or prior 2 weeks). CVD events, including myocardial infarction, stroke, heart failure, percutaneous coronary intervention, and bypass surgery, were assessed via interviews and, for a subset of participants, were verified through medical records.

A total of 231 of 3272 participants had experienced a CVD event over the course of follow-up. Ultimately, data indicated that frequent VMS at baseline were associated with a doubled risk of clinical CVD events later in life. Hazard ratios (HRs) were 1.05 for VMS occurring 1 to 5 days, and 1.62 for at least 6 days compared with no VMS. In addition, the researchers noted, more visits with frequent VMS over time were associated with an increased risk for later CVD events (HR 2.01 compared with no VMS).

Notably, the association between VMS and CVD was not explained by standard CVD risk factors, as persistent hot flashes occurring over the course of follow-up were found to be associated with an 80% higher risk of clinical CVD events in the 20 years that followed.

“This is the strongest test of whether hot flashes are associated with actual clinical CVD events, such as heart attacks and strokes, which represent the most clinically relevant outcome,” said lead study author Rebecca Thurston, PhD, from the University of Pittsburgh, in a press release.2

“With heart disease being the number one killer of women, it’s critical that we understand its many different risk factors in order to help create more preventative and treatment strategies for women transitioning through menopause,” says Stephanie Faubion, MD, medical director of NAMS, in a press release.2

—Christina Vogt

References:

  1. Thurston RC, Vlachos H, Derby CA, et al. Vasomotor symptoms and risk of cardiovascular disease events in the Study of Women’s Health Across the Nation. Paper presented at: North American Menopause Society Annual Meeting; September 25-28, 2019; Chicago, IL.
  2. Hot flashes shown to be linked to increased risk of later cardiovascular disease events [press release]. Cleveland, OH. North American Menopause Society. September 24, 2019. Accessed September 24, 2019.