Frequent, persistent hot flashes predict later CVD events

Frequent and persistent hot flashes during menopause can majorly raise women’s risk of clinical CVD events in the following 20 years, researchers reported at the 30th Annual Meeting of the North American Menopause Society.

While past research has established a tenuous link between CVD risk and hot flashes, those studies have relied on subclinical measures of disease rather than “hard” clinical events like MI or stroke. They’ve also failed to establish a good, dependable measure of hot flash frequency, opting instead to rely on women’s memories of their experiences, which are often biased.

Rebecca Thurston, of the University of Pittsburgh, and her team leveraged SWAN (Study of Women’s Health Across the Nation) data to test whether the timing or frequency of hot flashes could help inform women’s future cardiovascular risk. The SWAN study is a longitudinal, 20-year study of the transition to menopause and assessed hot flashes regularly as part of its protocol.

Thurston et al. found that both frequency and persistence of hot flashes were associated with a higher CVD risk—something that couldn’t be explained by traditional CVD risk factors. Frequent hot flashes toward the beginning of the study were linked to double the risk of clinical CVD events in the two decades following menopause; persistent hot flashes over the course of the study were linked to an 80% increased risk.

“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,” Thurston said in a statement. “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.”