Independent association of palpitation with vasomotor symptoms and anxiety in middle-aged women

Abstract

Objective: Palpitation, or the sensation of rapid or irregular heartbeats, is common in menopausal women; however, the precise underlying mechanisms are unknown. We aimed to investigate factors associated with palpitation in middle-aged women. Methods: Medical records of 394 women aged 40 to 59 years (108 premenopausal, 85 perimenopausal, and 201 postmenopausal) were analyzed cross-sectionally. Palpitation severity was estimated based on responses to the Menopausal Symptom Scale. Effects of background characteristics, including age, menopausal status, body composition, cardiovascular parameters, basal metabolism, physical fitness, lifestyle factors, vasomotor, and psychological symptoms on palpitation were assessed using multivariate logistic regression analysis. The association between autonomic nervous system activity and palpitation was also analyzed in 198 participants. Results: Prevalence of palpitation by severity was as follows: none, 26.4%; mild, 32.7%; moderate, 29.4%; severe, 11.4%. In univariate analyses, the more severely the women were affected by palpitation, 1) the higher their systolic blood pressure, 2) the less exercise they performed, 3) the lower they scored in the sit-and-reach test, 4) the higher their vasomotor symptoms score in the Menopausal Health Related-Quality of Life questionnaire, and 5) the higher their Hospital Anxiety and Depression Scale. Multiple logistic regression analysis revealed that moderate to severe palpitation was independently associated with the vasomotor symptom score (adjusted odds ratio [95% confidence interval]: 1.18 [1.07-1.31]) and Hospital Anxiety and Depression Scale anxiety subscale score (1.19 [1.12-1.27]). Conclusions: Rapid or irregular heartbeats are highly prevalent in middle-aged women. It is not associated with age, menopausal status, heart rate, arrhythmia, autonomic nervous system activity, caffeine, or alcohol consumption, but with vasomotor symptoms and anxiety.

Nutritional Risk Factors Associated with Vasomotor Symptoms in Women Aged 40–65 Years

“…Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated. Several models were proposed: an unadjusted model (Model 1); an adjusted model (Model 2) including covariates (age (years), hormone use (yes or no), and daily physical activity (MET/day)); and an adjusted model (Model 3) including covariates (stage of reproductive aging (late reproductive, menopausal transition, early postmenopause, or late postmenopause), hormone use (yes or no), daily physical activity (MET/d), alcohol intake (mL/day), and caffeine intake (mg/day)) [25][26][27]. Model 2 was adjusted to include age as a covariate because VMS follows a natural pattern according to lifespan [28].…”

Correlates of palpitations during menopause: A scoping review

“…Only 2% of articles included the word “palpitations” in the title. 47 , 58 Articles originated from multiple regions, most frequently from Asia (East, North, South East, South total n = 31, 37%). Only one article included participants from multiple world regions.…”

“… 39 In contrast, in three articles, there were no significant differences in palpitations across low, moderate, and high physical activity groups 54 , 104 or between those who did and did not report regular exercise. 58 …”

“… Superscripted numbers are the article reference citations. a Comorbidities included human immunodeficiency virus, 36 , 59 , 78 osteopenia/osteoporosis, 37 metabolic syndrome, 49 , 74 atherosclerosis, 58 arrhythmias, 58 risk of sarcopenia, 62 diabetes, 84 thyroid tumor, 86 and Celiac disease. 96 …”

Anxiety and hot flashes as predictors of mid-life palpitations: getting to the heart of the matter in the time of COVID-19

“…It was within this context that I read the work by Enomoto et al 2 who report in this issue of Menopause on factors associated with the prevalence and severity of self-reported palpitations in middle-aged Japanese women. Study participants were ages 40 to 59 attending a Tokyo menopause clinic between 2007 and 2020 (presumably pre-COVID).…”