“Hot flashes were considered solely quality of life issues. Few
investigators have considered their links with women’s heart
health,” lead author Rebecca Thurston of the Women's Biobehavioral
Health Laboratory at the University of Pittsburgh told Reuters
Health by email.
In their study of 272 postmenopausal women, ages 40 to 60, Thurston
and her team found a connection between hot flashes at younger ages
and impaired function of the lining of the women’s blood vessels.
The health of the lining, known as the endothelium, is commonly
assessed by measuring how well the endothelial cells respond to
signals that would ordinarily cause the blood vessel to expand.
In women who were having hot flashes at ages 40 to 53, the
endothelial cells lining the artery showed poorer responsiveness to
those signals, which is typically an indication of increased risk
for cardiovascular disease later in life.
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This was not true for women of the same age who were not having hot
flashes. Nor was the link between hot flashes and endothelial
dysfunction seen among older women, ages 54 to 60 years.
None of the women were smokers, and none of them had been diagnosed
with any cardiovascular diseases.
Cardiovascular disease is the leading cause of women's death, and
hot flashes affect 70 percent of women, Thurston said.
Each hot flash can last about a minute or so, and they occur over
the course of a decade for many women. The participants in the study
showed an average of six recorded hot flashes per 24-hour period.
For reasons as yet unknown, waking hot flashes may indicate a higher
risk than hot flashes during sleep, the researchers found.
Whereas previous studies regarding hot flashes and cardiovascular
risk were observational and based on reports by the women
themselves, this new study involved real-time hot flash monitoring,
blood tests, and ultrasound measurement of blood flow in the arm.
For this reason, the investigators say, their results are superior
to previous studies.
The researchers also took into account women’s other cardiovascular
risk factors and the lower levels of estrogen found in older women,
which itself can cause poorer blood vessel function.
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A weakness of the study was that the average participant was white
and college educated, which might mean the results don’t apply to
other types of women.
Dr. JoAnn Manson of Brigham and Women’s Hospital and Harvard Medical
School in Boston was one of the lead investigators on a 2011 study
of participants in the large-scale Women’s Health Initiative which
found a similar connection between hot flashes and impaired blood
vessel dilation – but in women ages 54 to 60.
“The relationship between menopausal hot flashes and cardiovascular
risk remains controversial, and this paper does not provide a
definitive answer,” Manson told Reuters Health by email.
“In the present study, an association between hot flashes and
impaired blood vessel dilation was found in the youngest women, but
not in women aged 54-60 (who were in early-to-middle stages of
menopause),” said Manson. “In the Women’s Health Initiative, the
largest study to date, the opposite was found: hot flashes in late,
but not early menopause, were linked to increased cardiovascular
risk. Thus, the hot flashes-cardiovascular disease puzzle continues
to be incomplete, with many missing pieces.”
In the meantime, the American Heart Association points out on its
website that preventing cardiovascular diseases requires "smart
choices." The AHA adds, "Lack of exercise, a poor diet and other
unhealthy habits can take their toll over the years. . . . No matter
what your age, everyone can benefit from a healthy diet and adequate
physical activity.”
SOURCE: http://bit.ly/2oREFN1 Menopause, online April 10, 2017.
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