Cutaneous and hemodynamic responses during hot flashes in symptomatic postmenopausal women

The aim of this study was to test the hypothesis that the postmenopausal hot flash is accompanied by rapid decreases in arterial blood pressure and increases in cutaneous vascular conductance (CVC), as evaluated by continuous measurements of these variables in symptomatic women.

Twelve healthy, normotensive, postmenopausal women rested in a temperature-controlled laboratory (26 degrees C) for approximately 90 minutes. The onset of a hot flash was objectively identified as a transient and pronounced elevation of sternal sweat rate (capacitance hygrometry).

Twenty-three hot flashes were recorded during the experimental sessions (3.4 +/- 1.4 min; range, 1.3-6.5 min). Mean arterial blood pressure decreased 13 +/- 2 mm Hg during 11 hot flashes in five participants. Data from these participants, categorized as responders, were analyzed separately from data for those participants whose blood pressure did not change during their hot flashes (n = 7, 12 hot flashes). Heart rate (obtained from an electrocardiogram) significantly increased during the hot flashes, but there was no difference between the responder and nonresponder groups (9 +/- 2 vs 10 +/- 1 beats/min, respectively; P > 0.05). The increase in CVC was not different between groups at either the forearm (15% +/- 3% vs 12% +/- 3% maximal CVC, P > 0.05) or sternum (24% +/- 5% vs 21% +/- 3% maximal CVC, P > 0.05).

These data demonstrate that in a subset of participants, the hot flash is accompanied by a significant reduction in blood pressure, but there is no difference in CVC between these women and women with no drop in blood pressure.