Earlier Hot Flashes Associated With Poorer Endothelial Function

Acculturation Affects Menopause in Hispanic Women
Acculturation Affects Menopause in Hispanic Women
Experiencing hot flashes earlier in life appears to be linked to poorer endothelial function in women.

Women who experience hot flashes earlier in life were at an increased risk for poorer endothelial function when compared with women who had hot flashes later in life or not at all, results from two studies presented at the American College of Cardiology (ACC) Scientific Sessions 2015 indicate.

In the MsHeart study, Rebecca C. Thurston, PhD, from the University of Pittsburgh, and fellow researchers enrolled 189 peri- and postmenopausal women aged 40 to 60 years (mean age, 54 years) who did not have heart disease. Patients were also not on hormone therapy, beta-blockers, calcium channel blockers, insulin or antidepressants.

To determine the relationship between hot flashes and flow-mediated dilation (FMD), researchers performed 24-hour physiologic hot flash monitoring and brachial artery ultrasound FMD testing.

According to data, FMD occurred in 6.3% of patients; the number of hot flashes per 24-hour period was eight; and 22% of women were non-white.

Researchers found that the relationship between hot flashes and FMD varied significantly by age (P=.02). Specifically, they observed that more physiologic hot flashes were associated with lower FMD in women of the youngest age tertile (age ≤52 years; P=.04); this was not the case, however, in women in the middle (age, 53 to 56 years; P=.20) or older (age ≥57 years; P=.48) age tertiles.

Results of a second study — analysis of the Women’s Ischemia Syndrome Evaluation (WISE) study — also confirmed the association between early vasomotor symptoms (VMS), including hot flashes and night sweats, and FMD.

For the study, Dr. Thurston and colleagues examined 104 postmenopausal women (mean age, 67 years; 10% non-white) not on hormonal therapy who underwent both coronary angiography and brachial artery ultrasound FMD testing.

Researchers categorized VMS history as follows: never; VMS beginning age ≤42 (early-onset); and VMS beginning age ≥42 (traditional-onset).

Median FMD was 1.56%, according to the data.

In linear regression models, early-onset VMS correlated with significantly lower FMD when compared with traditional-onset VMS (P=.038). However, there were no differences between the never VMS and traditional-onset VMS groups (P=.42).

These relationships remained after controlling for age, race, hormone use history and obstructive coronary artery disease.

“Hot flashes occur at a time in a woman’s life when her risk for heart disease increases,” Dr. Thurston said in a press release. “Because current cardiovascular risk algorithms do not always predict clinical cardiovascular disease well for midlife women, gaining a better understanding of the role vasomotor symptoms might play on vascular health could help identify women most at risk.”


  1. Thurston RC et al. Abstract 1246-116.
  2. Thurston RC et al. Abstract 1246-117. Both presented at: American College of Cardiology (ACC) 64th Annual Scientific Session & Expo; March 14-16, 2015; San Diego.