Physiologically assessed hot flashes and endothelial function among midlife women.
Level 4 - case-series / case-control
Cross-sectional observational study
PubMed 30358732 · doi:10.1097/GME.0000000000001239
What was done
The study evaluated 272 nonsmoking women aged 40 to 60 years without clinical cardiovascular disease who reported either daily hot flashes or no hot flashes. Participants underwent ambulatory physiologic hot flash monitoring, self-reported diary tracking, blood testing for estradiol and cardiovascular risk factors, and brachial artery ultrasound to assess flow-mediated dilation. Multivariable linear regression models tested associations between hot flash measures and flow-mediated dilation, adjusting for lumen diameter, demographics, cardiovascular risk factors, and estradiol, and evaluating effect modification by age.
What was found
Age significantly modified the association (interaction P < 0.05). Among women in the younger tertile (age 40 to 53 years), the presence of hot flashes was associated with lower flow-mediated dilation (beta [SE] = -2.07 [0.79], P = 0.01), and each additional physiologic hot flash was associated with further reductions in flow-mediated dilation (beta [SE] = -0.10 [0.05], P = 0.03). These associations remained after adjusting for estradiol and standard cardiovascular risk factors. No significant associations were observed in older women (age 54 to 60 years) or with self-reported hot flash frequency, severity, or bother.
Why it matters
Physiologically measured hot flashes, rather than self-reported symptoms, correlate with endothelial dysfunction in younger midlife women independently of standard cardiovascular risk markers and estradiol levels.
Limits
The cross-sectional design precludes causal inference or determination of temporal sequence. Findings were restricted to an age-subgroup analysis, and the sample excluded smokers and individuals with pre-existing clinical cardiovascular disease.
Cited by
- partial Vasomotor hot flashes represent bodywide vascular spasms.