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

Gordon, Jennifer L.; Rubinow, David R.; Thurston, Rebecca C.; Paulson, Julia L.; Schmidt, Peter J.; Girdler, Susan S.

doi:10.1097/gme.0000000000000689

Cited by 38 publications

(28 citation statements)

References 55 publications

(58 reference statements)

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“…34 The disturbances in the ANS and HPA axis may serve as a common link between VMS and CVD. 35,36 Hot flashes and night sweats may lead to different physiological changes in women. In one study, women with daytime hot flashes were reported to be leaner and had lower systolic blood pressure than women with night sweats.…”

Section: Mechanismsmentioning

confidence: 99%

Vasomotor menopausal symptoms and risk of cardiovascular disease: a pooled analysis of six prospective studies

Zhu

Chung

Dobson

et al. 2020

American Journal of Obstetrics and Gynecology

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BACKGROUND: Menopausal vasomotor symptoms (ie, hot flashes and night sweats) have been associated with unfavorable risk factors and surrogate markers of cardiovascular disease, but their association with clinical cardiovascular disease events is unclear. OBJECTIVE: To examine the associations between different components of vasomotor symptoms, timing of vasomotor symptoms, and risk of cardiovascular disease. STUDY DESIGN: We harmonized and pooled individual-level data from 23,365 women in 6 prospective studies that contributed to the International Collaboration for a Life Course Approach to Women's Reproductive Health and Chronic Disease Events consortium. Women who experienced cardiovascular disease events before baseline were excluded. The associations between frequency (never, rarely, sometimes, and often), severity (never, mild, moderate, and severe), and timing (before or after age of menopause; ie, early or late onset) of vasomotor symptoms and incident cardiovascular disease were analyzed. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals. RESULTS: In the adjusted model, no evidence of association was found between the frequency of hot flashes and incident cardiovascular disease, whereas women who reported night sweats "sometimes" (hazard ratio, 1.22; 95% confidence interval, 1.02e1.45) or "often" (hazard ratio, 1.29; 95% confidence interval, 1.05e1.58) had higher risk for cardiovascular disease. Increased severity of either hot flashes or night sweats was associated with higher risk of cardiovascular disease. The hazards ratios of cardiovascular disease in women with severe hot flashes, night sweats, and any vasomotor symptoms were 1.83 (95% confidence interval, 1.22e2.73), 1.59 (95% confidence interval, 1.07e2.37), and 2.11 (95% confidence interval, 1.62e2.76), respectively. Women who reported severity of both hot flashes and night sweats had a higher risk for cardiovascular disease (hazard ratio, 1.55; 95% confidence interval, 1.24e1.94) than those with hot flashes alone (hazard ratio, 1.33; 95% confidence interval, 0.94e1.88) and night sweats alone (hazard ratio, 1.32; 95% confidence interval, 0.84e2.07). Women with either early-onset (hazard ratio, 1.38; 95% confidence interval, 1.10e1.75) or late-onset (hazard ratio, 1.69; 95% confidence interval, 1.32e2.16) vasomotor symptoms had an increased risk for incident cardiovascular disease compared with women who did not experience vasomotor symptoms. CONCLUSION: Severity rather than frequency of vasomotor symptoms (hot flashes and night sweats) was associated with increased risk of cardiovascular disease. Vasomotor symptoms with onset before or after menopause were also associated with increased risk of cardiovascular disease.

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Section: Mechanismsmentioning

confidence: 99%

Vasomotor menopausal symptoms and risk of cardiovascular disease: a pooled analysis of six prospective studies

Zhu

Chung

Dobson

et al. 2020

American Journal of Obstetrics and Gynecology

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“…However, because we found an association between hot flashes and MetS, future studies could consider the occurrence of hot flashes as a risk marker for CVD and MetS. In fact, there have been numerous studies showing that hot flashes are associated with activation of the hypothalamic-pituitary-adrenal axis, with the release of cortisol, and with norepinephrine stimulation 24,25 . Therefore, the only way to establish causality among these factors in a more consistent manner is to conduct longitudinal cohort studies.…”

Section: Discussionmentioning

confidence: 72%

Prevalence of hot flashes in women of 40 to 65 years of age with metabolic syndrome

Saú

Schmitt

Cardoso

et al. 2020

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: Hot flashes have a negative impact on the quality of life of women during the menopausal transition and thereafter. The progressive reduction in gonadal estrogen levels associated with aging promotes an accumulation of abdominal fat, dyslipidemia, and arterial hypertension, all of which are components of metabolic syndrome (MetS). The objective of the present study was to estimate the prevalence of hot flashes and evaluate their relationship with MetS in women ≥ 40 years of age. METHODS: This was a cross-sectional study involving women aged between 40 and 65 years. We used the Kupperman index to quantify the climacteric symptoms and the National Cholesterol Education Program Adult Treatment Panel III criteria for the diagnosis of MetS. RESULTS: 1,435 women were initially selected, and we obtained information from 647. The mean age at menopause was 45.99 years (SD 6.61 years) and the prevalence of hot flashes and MetS were 55.83% (95% CI: 52.35-59.25%) and 46.29% (95% CI: 44.75-52.53%), respectively. We identified a positive association between MetS and hot flashes (OR 1.16; 95% CI: 1.01-1.33). CONCLUSIONS: In women ≥ 40 years of age, hot flashes are highly prevalent and appear to be associated with MetS.

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“…In the group of premenopausal patients with VMS, there was a positive correlation between the PLR and baseline arterial diameter, which indicates that women with hot flashes have greater inflammation that affects the vascular endothelium [ 9 , 40 - 42 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship of the neutrophil/lymphocyte ratio with cardiovascular risk markers in premenopausal and postmenopausal women

Carranza-Lira

Montiel

Camacho

et al. 2020

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Introduction Cardiovascular disease is more frequent in postmenopausal women. Atherosclerosis is associated with inflammation and the neutrophil/lymphocyte ratio (NLR) is a marker of inflammation whose behavior in postmenopause is unknown. Aim of the study To know the relationship of the NLR with cardiovascular risk markers in premenopausal and postmenopausal women. Material and methods Premenopausal and postmenopausal women were studied, in all of them a complete hemogram and the NLR, platelet/lymphocyte ratio (PLR) were calculated, also glucose and lipids levels were measured. In all of them subcutaneous and visceral fat, carotid intima-media thickness (IMT), epicardial fat were measured by ultrasound Also baseline and and after flow-mediated stimulus the arterial diameter, the pulsatility index and the resistive index of the brachial artery were measured by ultrasound. The results are reported with medians and intervals, Mann-Whitney U and Spearman correlation analysis were performed. Results Eighty two patients were recruited, 41 premenopausal and 41 postmenopausal. When comparing both groups there was no difference in glucose, lipids, NLR, PLR, carotid IMT, epicardial fat, subcutaneous fat, visceral fat or Doppler parameters of the brachial artery. Conclusion NLR was not different between premenopausal and postmenopausal women but abnormal PLR was greater in those postmenopausal with vasomotor symptoms.

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

Cited by 38 publications

References 55 publications

Vasomotor menopausal symptoms and risk of cardiovascular disease: a pooled analysis of six prospective studies

Vasomotor menopausal symptoms and risk of cardiovascular disease: a pooled analysis of six prospective studies

Prevalence of hot flashes in women of 40 to 65 years of age with metabolic syndrome

Relationship of the neutrophil/lymphocyte ratio with cardiovascular risk markers in premenopausal and postmenopausal women

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