In a recent article in the American Journal of Obstetrics and Gynecology, researchers examined the correlations between different components of menopausal vasomotor symptoms with the risk of cardiovascular disease (CVD). According to the study, among women with menopausal vasomotor symptoms (VMS), the severity, not the incidence, of hot flushes and night sweats is linked to a greater risk of CVD. 

The researchers utilized pooled individuals level data from 23,365 women in six prospective studies. Women who experienced CVD events before baseline were eliminated. The connections between frequency (never, rarely, sometimes, and often), severity (never, mild, moderate, and severe), and timing (before or after age of menopause, i.e., early or late onset) of VMS and incident CVD were examined. Cox proportional hazards models were utilized to estimate hazard ratios (HR) and 95% confidence intervals (CI).

The scientists, Dongshan Zhu, PhD, from the University of Queensland in Brisbane, Australia, and colleagues indicated that no evidence of correlation was found between frequency of hot flushes and incident CVD, while women who reported episodes of night sweats, “sometimes” (HR 1.22, 95% CI 1.02-1.45) or “often” (1.29, 1.05-1.58) had a higher risk of CVD. Increased severity of either hot flushes or night sweats was associated with a  higher risk of CVD. The HRs of CVD in women with severe hot flushes, night sweats and any VMS were 1.83 (1.22, 2.73), 1.59 (1.07, 2.37), and 2.11 (1.62, 2.76), respectively. 

The study noted that women who reported severity for both hot flushes and night sweats had a greater risk of CVD (1.55, 1.24-1.94) than those with hot flushes alone (1.33, 0.94-1.88) and night sweats alone (1.32, 0.84-2.07). Women with early-onset (1.38, 1.10-1.75) or late-onset (1.69, 1.32-2.16) VMS had an expanded risk of incident CVD, compared with women who did not experience VMS. The researchers concluded that severity rather than incidence of hot flushes and night sweats is linked to a greater risk of CVD. Moreover, VMS before menopause or after menopause were correlated with an increased risk of incident CVD. 

The researchers noted that identifying women with elevated VMS severity who are transitioning to menopause offers clinicians a window of opportunity to implement active management of other CVD risk factors to enhance these individuals’ overall cardiovascular health. Finally, they concluded that women in this patient population may also require close monitoring in clinical practice. 
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