Hot flushes, vascular reactivity and the role of the α-adrenergic system

Sassarini, Jenifer; Fox, Henrik; Ferrell, William R.; Sattar, Naveed; Lumsden, Mary-Ann

doi:10.3109/13697137.2011.636847

Cited by 17 publications

(11 citation statements)

References 38 publications

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“…Notably, hot flashes may be associated with greater reactivity of the microvasculature, a response often mediated by the sympathetic nervous system. 49 Emerging work also links the hypothalamic pituitary adrenal axis to hot flashes, 50 which is also associated with poorer vascular health. 51 These pathways should be considered in future work.…”

Section: Discussionmentioning

confidence: 99%

Physiologically assessed hot flashes and endothelial function among midlife women

Thurston

Chang²,

Barinas‐Mitchell

et al. 2017

Menopause

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Objective Hot flashes are experienced by most midlife women. Emerging data indicate that they may be associated with endothelial dysfunction. No studies have tested whether hot flashes are associated with endothelial function using physiologic measures of hot flashes. We tested whether physiologically-assessed hot flashes were associated with poorer endothelial function. We also considered whether age modified associations. Methods 272 nonsmoking women reporting either daily hot flashes or no hot flashes, aged 40-60, and free of clinical cardiovascular disease underwent ambulatory physiologic hot flash and diary hot flash monitoring; a blood draw; and ultrasound measurement of brachial artery flow mediated dilation to assess endothelial function. Associations between hot flashes and flow mediated dilation were tested in linear regression models controlling for lumen diameter, demographics, cardiovascular disease risk factors, and estradiol. Results In multivariable models incorporating cardiovascular disease risk factors, significant interactions by age (p<.05) indicated that among the younger tertile of women in the sample (ages 40-53), the presence of hot flashes [beta(standard error)=-2.07 (.79), p=.01], and more frequent physiologic hot flashes were associated with lower flow mediated dilation [for each hot flash: beta(standard error)=-.10(.05), p=.03, multivariable]. Associations were not accounted for by estradiol. Associations were not observed among the older women (ages 54-60) or for prospective-reported hot flash frequency, severity, or bother. Among the younger women, hot flashes explained more variance in flow mediated dilation than standard cardiovascular disease risk factors or estradiol. Conclusions Among younger midlife women, frequent hot flashes were associated with poorer endothelial function and may provide information about women's vascular status beyond cardiovascular disease risk factors and estradiol.

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Section: Discussionmentioning

confidence: 99%

Physiologically assessed hot flashes and endothelial function among midlife women

Thurston

Chang²,

Barinas‐Mitchell

et al. 2017

Menopause

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“…Due to loss of sleep, interruption of social life and ability to work, many menopausal women will seek medical care related to vasomotor symptoms. The combination of a narrowed hypothalamic thermoregulatory zone and increased vascular reactivity make the menopausal woman more vulnerable to hot flushes and night sweats [3]. Minimal changes in temperature from things like hot drinks, stress, and medications can induce a hot flush [4].…”

Section: Discussionmentioning

confidence: 99%

“…This central mechanism is not fully understood and may include peripheral vascular responses. Menopausal women who experience flushing have been shown to have significantly increased peripheral vascular reactivity as compared to women who do not [3]. The narrowed regulatory zone responds to small elevations in body temperature by dilating the already overly reactive peripheral vasculature to dissipate excess heat [4].…”

Section: Introductionmentioning

confidence: 99%

Linaclotide and Vasomotor Symptoms

Schuneman

Wald²,

Hansen

2015

OGIJ

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Objective: To report a case of a peri-menopausal woman with acute onset vasomotor symptoms following initiation of Linaclotide. Study Design:The study was carried out by a case report. Results:A 52-year-old woman with acute onset of hot flushes and night sweats following initiation of Linaclotide for irritable bowel syndrome/constipation. The symptoms slowly improved and stopped after 4 months of Linaclotide use. Conclusions:The fundamental pathophysiology of menopausal vasomotor symptoms remains enigmatic. Side effects of phosphodiesterase 5 inhibitors, such as Sildenafil, which increases cGMP, include hot flushes. Linaclotide is a potent guanylate cyclase-C agonist which elevates cyclic GMP primarily in the intestine with minimal absorption. Even minimal absorption may be enough to cause vasodilatation and in the peri-menopausal patient, trigger vasomotor symptoms. Keywords

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“…At night, hot flushes and night sweats will often cause insomnia that leads to fatigue. The mechanism of VMSs appears to involve the central nervous system, possibly linked to a narrowing of the thermoregulatory neutral zone in women with hot flushes, and is associated with instability of the skin blood vessels …”

Section: Introductionmentioning

confidence: 99%

Vasomotor symptoms resulting from natural menopause: a systematic review and network meta‐analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause

Sarri

Pedder

Dias

et al. 2017

BJOG

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Hot flushes, vascular reactivity and the role of the α-adrenergic system

Abstract: Background: 70% of postmenopausal women suffer from hot flushes but the pathophysiology is

Cited by 17 publications

References 38 publications

Physiologically assessed hot flashes and endothelial function among midlife women

Physiologically assessed hot flashes and endothelial function among midlife women

Linaclotide and Vasomotor Symptoms

Vasomotor symptoms resulting from natural menopause: a systematic review and network meta‐analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause

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