Hot flashes and the Risk of Heart Disease

Frequent and severe occurrence of perimenopausal symptoms, such as hot flashes, could be linked to a higher risk of cardiovascular disease, reported Menopause, the journal of the North American Menopause Society.

Previous studies have linked hot flashes, a common manifestation of perimenopause, to arterial stiffening and vascular dysfunction, both associated with an increased risk in heart disease, NAMS said. But the earlier studies relied on subclinical measures of cardiovascular disease (CVD) or on women recalling hot flashes from years earlier, which can bias results.

However, the Study of Women’s Health Across the Nation (SWAN), a longitudinal 20-year study of the menopause transition, was able to confirm the hot flash-cardiovascular disease link because it assessed hot flashes regularly throughout the menopause transition and also collected information on cardiovascular disease events as women age.

“This is the strongest test of whether hot flashes are associated with actual clinical CVD events, such as heart attacks and strokes, which represent the most clinically relevant outcome,” Dr. Rebecca Thurston, lead author of the study from the University of Pittsburgh, said.

“It’s the strongest because we measured hot flashes prospectively multiple times over the course of the menopause transition, which is different than most other studies of CVD events that ask women to recall their hot flashes over months or years. We also had measures of clinical CVD events, rather than other proxy measures. We brought these data together to address this important question in a more rigorous fashion than prior studies.”

**Because heart disease is the top killer of women, “it’s critical that we understand its many different risk factors in order to help create more preventative and treatment strategies for women transitioning through menopause,” said Dr. Stephanie Faubion, NAMS medical director. **

In the study, which evaluated 138 menopausal women, also evaluated depression’s link to cardiovascular disease, as well as quality-of-life measures, AARP explained. While researchers found that a low quality of life also was found to be associated with a higher risk of CVD, no link could be found with depressive symptoms.

Women typically experience perimenopause and menopause in their late 40s to early 50s.

NAMS Executive Director JoAnn Pinkerton suggested that women who experience difficult and frequent symptoms discuss these matters with their healthcare provider, as well as “know their numbers” for blood pressure, blood sugars and lipid levels “as these affect their risk of developing heart disease.”

Pinkerton also recommended lifestyle changes for women experiencing perimenopause and beyond to incorporate aerobic exercise, stress management, a healthy diet and healthy weight range to help decrease the risk of heart disease.

Study results were presented during The North American Menopause Society’s annual meeting in September 2019.