Hot flushes and night sweats are associated with coronary heart disease risk in midlife: a longitudinal study

Abstract

Objective The purpose of this study was to investigate associations between vasomotor menopausal symptoms (VMS), i.e. hot flushes and night sweats, and the incidence of coronary heart disease (CHD).Design A prospective cohort study.Setting and population 11 725 women, aged 45-50 years at baseline in 1996, were followed up at 3-year intervals for 14 years.Methods Self-reported VMS and incident CHD were measured at each survey.Main outcome measure We determined the association between VMS and CHD at the subsequent survey, using generalised estimating equation analysis, adjusting for time-varying covariates.Results At baseline, 14% reported rarely, 17% reported sometimes, and 7% reported often having night sweats. During follow-up, 187 CHD events occurred. In the age-adjusted analysis, women who reported their frequency of experiencing hot flushes and night sweats as 'often' had a greater than two-fold increased odds of CHD (OR hot flushes 2.18, 95% CI 1.49-3.18; OR night sweats 2.38, 95% CI 1.62-3.50) compared with women with no symptoms (P trend < 0.001 for frequency of symptoms). Adjustment for menopausal status, lifestyle factors, body mass index, diabetes, and hypertension attenuated the associations (OR hot flushes 1.70, 95% CI 1.16-2.51, P trend = 0.01; OR night sweats 1.84, 95% CI 1.24-2.73), P trend = 0.004).Conclusions Women who report having hot flushes or night sweats 'often' have an increased risk of developing CHD over a period of 14 years, even after taking the effects of age, menopause status, lifestyle, and other chronic disease risk factors into account.

Vasomotor symptoms in menopause: a biomarker of cardiovascular disease risk and other chronic diseases?

“…Women with severe hot flushes may have an increased sympathetic tone with vascular involvement 15 . What is, however, now clear is that hot flushes (previously thought to be solely due to decreased estrogen levels) are a complex multicausal phenomenon and reflect a combination of interconnected systems including genetic bases, diet, physical changes, use of medications, cultural influences, and individual experiences and expectations [16][17][18] .…”

Cardiovascular, hemodynamic, neuroendocrine, and inflammatory markers in women with and without vasomotor symptoms

“…Although findings are not entirely consistent, with one study finding VMS to be associated with a decreased risk of cardiovascular disease mortality 3 , several recent studies suggest that VMS frequency and/or severity may be positively associated with cardiovascular disease risk. In one 14-year longitudinal study of over 11,000 women aged 45-50, women who reported having VMS ‘often’ had a two-fold increased risk of developing coronary heart disease (CHD) over the course of the study when compared to women who reported no VMS 4 . Furthermore, the Women's Health Initiative Observational Study (WHIOS), involving approximately 60,000 postmenopausal women aged 50 to 79 who were followed for an average of 9.7 years, 5 found that VMS, particularly late-onset VMS, were associated with an increased risk of major CHD, stroke and total cardiovascular disease (HRs = 1.30-1.46).…”

Midlife women's cardiovascular symptoms: A cluster analysis

“…High vasomotor symptoms are associated with overactive of the sympathetic nervous system, and sympathetic overdrive in turn is associated with metabolic symptoms, which is a known risk factor of CVDs (Tuomiloski, & Savolainen-Peltonen, 2017). In addition, in a longitudinal study, it was confirmed that women having hot flushes or night sweats often had an increased risk of developing coronary heart diseases (Herber-Gast, Brown, & Mishar, 2015). Furthermore, it is known that women with CVDs report atypical symptoms such as unusal fatigue, sleep disturbance, nausea, vomiting, dyspena, and weakness rather than typical cardiovascular symptoms (McSweeney et al, 2010).…”