For women in midlife, an earlier age of onset of vasomotor symptoms – hot flashes and night sweats – was linked to impaired endothelial function, a very early marker for cardiovascular disease.
In the first of two related studies, an earlier age of onset for vasomotor symptoms (VMS) was associated with increased endothelial dysfunction as measured by brachial artery ultrasound. Greater frequency of hot flashes was associated with endothelial dysfunction for younger but not older participants in the second study.
Though more than 70% of women experience VMS during perimenopause and menopause, these symptoms largely have been viewed as a quality of life issue. However, this emerging research might mean that early onset of of hot flashes might serve a potential marker for increased risk for cardiovascular disease, said Rebecca C. Thurston, Ph.D., associate professor of psychiatry, psychology, and epidemiology at the University of Pittsburgh. Her work was presented in a briefing in advance of the annual meeting of the American College of Cardiology in San Diego.
Dr. Thurston and her colleagues drew from the Women’s Ischemia Syndrome Evaluation (WISE) study to evaluate 104 women at four study sites. Participants were postmenopausal and at least 50 years old, could not be on hormone replacement therapy, and had their ovaries. Women with any signs or symptoms of ischemia were excluded, and multiple potential confounders were assessed in the study’s extensive evaluation. Women were stratified by onset of VMS by self-report into three groups: those who never had VMS, those whose VMS began at age 42 or earlier, and those whose VMS began after the age of 42.
Women in the WISE study underwent brachial artery ultrasound to assess brachial artery flow mediated dilation (FMD), a known preclinical disease marker that has been linked to clinical outcomes. Lower FMD scores indicate poorer endothelial function. Women in the group with the earliest onset of VMS had significantly lower FMD values (P = 0.038), indicating poorer endothelial dysfunction. The effect persisted even after controlling for potentially confounding factors.
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