Frequent Hot Flashes Worsened Endothelial Function in Younger Midlife Women

Age significantly affected the association between hot flash status and flow-mediated dilation, particularly in younger women.

Frequent hot flashes in younger midlife women were associated with poorer endothelial function, according to a recent study published in Menopause.

These findings, the researchers wrote, may provide information about the vascular status of women beyond cardiovascular disease (CVD) risk factors and estradiol.

According to Rebecca C. Thurston, PhD, from the University of Pittsburgh School of Medicine and the University of Pittsburgh Graduate School of Public Health in Pennsylvania, and fellow study researchers, no studies had previously examined the link between hot flashes and endothelial function using physiologic hot flash measures.


This led them to conduct a study enrolling 272 nonsmoking women (aged 40-60 years) who reported either daily hot flashes or no hot flashes. Patients were free from clinical CVD and received ambulatory physiologic hot flash and diary hot flash monitoring, a blood draw, and ultrasound measurement of brachial artery flow-mediated dilation (FMD) to evaluate endothelial function.

The researchers performed multivariable model analysis that incorporated CV risk factors.

Results of the analysis indicated that age significantly affected the association between hot flash status and FMD. Specifically, for women in the younger tertile (aged 40-53 years), the presence of hot flashes (P =.01) and more frequent physiologic hot flashes (P =.03) yielded significantly lower FMD.

“Associations were not accounted for by estradiol,” the researchers reported.

However, no association was reported between hot flashes and FMD among older women (aged 54-60 years) in the study sample.

In addition, hot flashes explained more variability in FMD than standard CVD risk factors or estradiol in the younger population, the researchers noted.

“These findings point to the potential value in considering the role of not only hormones, but also hot flashes, in the cardiovascular changes that occur early in the menopause transition, while also underscoring the potential role that the endothelium may play in the physiology of early hot flashes,” the researchers concluded. “With further replication and extension of this work, these findings may indicate that among early midlife women, frequent hot flashes may signal emerging vascular dysfunction.”

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Thurston RC, Chang Y, Barinas-Mitchell E, et al. Physiologically assessed hot flashes and endothelial function among midlife women [published online April 10, 2017]. Menopause. doi:10.1097/gme.0000000000000857