Correlates of palpitations during menopause: A scoping review

Abstract

Objective: Palpitations during peri- and post-menopause are common. It is unclear what variables are related to palpitations in peri- and post-menopausal women. The purpose of this scoping review was to summarize potential correlates of palpitations in women transitioning through menopause. Methods: The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Authors included English-language, full-length, peer-reviewed, cross-sectional research articles on palpitations in menopausal women published through December 18, 2021, from PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO searches. Following de-duplication, screening of titles and abstracts, and review of full-texts, independent reviewers extracted data on variables studied in relationship to palpitations from 84 articles and resolved discrepancies. Authors extracted data on (1) demographic, clinical, biomarker, and symptom/quality of life variables and (2) data analysis method (bivariate, multivariate). Authors classified each variable as a likely, unlikely, or unclear correlate of palpitations. Results: Articles were diverse in region of origin, sample sizes, and variables assessed in relationship to palpitations. Evidence for any one variable was sparse. Likely correlates of palpitations included race/ethnicity, lower physical activity, worse vasomotor symptoms (VMSs), worse sleep, and worse quality of life. Unlikely correlates included age, employment, education, marital status, socioeconomic status, comorbidities, body mass index, and sexual difficulties. Unclear correlates due to equivocal evidence were menopausal status, smoking, and depression. Unclear correlates due to insufficient evidence (less than three articles) included all of the assessed biomarkers, anxiety, and stress. Conclusion: Likely correlates were identified including race/ethnicity, physical activity, VMS, sleep, and quality of life. However, additional research is needed to better understand potential correlates of palpitations.

“Quick flutter skip”: midlife women's descriptions of palpitations

“…5 If different subtypes emerged in a larger study, it might be possible to further identify their precipitating factors or antecedents (eg, demographics, gynecological history, menopause status) as well as their impact on health outcomes (eg, cardiovascular events). Although studies have attempted to identify precipitating factors or antecedents of palpitations in peri-and postmenopausal women, 4 little research has examined their long term impact. 2 The third finding was the variability in healthcare experiences described by the women.…”

“…Although much has been written about menopausal vasomotor symptoms, less has been written about menopausal palpitations. In peri- and postmenopausal women, more distress from palpitations is associated with worse sleep disturbance, 3,4 depressive symptoms, 3 stress, 3 and menopausal quality of life 3,4 . In the broader population, palpitations account for 16% of general physicians' visits and are the second leading reason for cardiologist visits 5 .…”

“…Very little is known about women's experiences of palpitations during the menopause transition. Two major gaps were identified based on recent reviews of the literature 4,7-9 . First, no published articles contain qualitative accounts of menopausal women's palpitations or their healthcare experiences related to this symptom.…”

Symptom reporting, cardiovascular disease, and mortality as women age: it is more than menopause

“…A review by Carpenter et al 10 finds that although estimates vary, up to 40% to 50% of midlife women may report palpitations, with the highest numbers among women in the perimenopause or who had undergone bilateral oophorectomy. Carpenter and colleagues 11 also find that key correlates of palpitations are race/ethnicity, lower physical activity, VMS, poor sleep, and poor quality of life. Another study associates palpitations to VMS and depressive/anxious symptoms 12 .…”

Palpitations across the menopause transition in SWAN: trajectories, characteristics, and associations with subclinical cardiovascular disease

“…5 In addition, the women most likely to experience palpitations over time have not been well characterized as the only two longitudinal studies included only women with breast cancer. It is unknown whether sociodemographic, reproductive, and health-related factors are shown to increase the likelihood of reporting palpitations in cross-sectional studies 4,6,7 are also related to the trajectories of palpitations over time.…”