Frequent or persistent vasomotor symptoms during the menopause transition are associated with increased risk for later cardiovascular disease (CVD) events, according to study results presented at the North American Menopause Society Annual Meeting, held September 25 to 28, 2019, in Chicago, Illinois.

Vasomotor symptoms during menopause have been associated with a worsened CVD risk profile, but had not previously been linked to clinical CVD. The study researchers aimed to use data from the longitudinal 20-year Study of Women’s Heath Across the Nation (SWAN) to identify the association between vasomotor symptoms and incident CVD events during the menopausal transition.

A total of 3272 premenopausal and perimenopausal women (aged 42-52 years) included in the study were followed for up to 20 years, and vasomotor symptoms and CVD events were assessed approximately annually. Vasomotor symptoms included hot flashes or night sweats, and CVD events included myocardial infarction, stroke, heart failure, percutaneous coronary intervention, or bypass surgery.

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Over the duration of the study, 231 women experienced a CVD event. Frequent baseline vasomotor symptoms (occurring 6 or more times within 2 weeks) were associated with increased risk for later CVD events compared with no vasomotor symptoms (hazard ratio, 1.62; 95% CI, 1.10-2.38; P =.01). Persistence of frequent vasomotor symptoms over the course of the study was also associated with increased risk for later CVD events (hazard ratio, 2.01; 95% CI, 1.30-3.11; P =.002).

“We find here that women with frequent hot flashes in early midlife (eg, their 40’s and early 50’s) or [persistent vasomotor symptoms] over the course of the menopause transition have increased risk for clinical CVD later in life, and that these associations were not explained by CVD risk factors,” Rebecca Thurston, PhD, director of the Women’s Biobehavioral Health Program at the University of Pittsburgh and lead author of the study, said in an interview with Endocrinology Advisor.

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“What we think is that women with a lot of hot flashes or persistent hot flashes over the menopause transition should stop smoking if they smoke, eat well, exercise, get their regular, recommended check-ups, and take medications as prescribed. Now is the time for women to prioritize their health. Often women are encouraged to put others first — their partners, children, and parents — but engaging in those healthy behaviors…is very important at midlife to prevent disease later in life.”

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Thurston RC, Vlachos H, Derby CA, et al. Vasomotor symptoms and risk of cardiovascular disease events in the Study of Women’s Health Across the Nation. Presented at: North American Menopause Society 2019 Annual Meeting; September 25-28, 2019; Chicago, IL. Session S-1.