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Biochemical markers for cardiovascular disease in recently postmenopausal women with or without hot flashes
Pauliina Tuomikoski1, Tomi S Mikkola, Esa Hämäläinen
1Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
Insights
Menopausal hot flashes do not appear to be linked to cardiovascular disease risk factors in early postmenopausal women. This finding suggests hot flashes alone may not explain conflicting hormone therapy study results.
Area of Science:
- Reproductive Endocrinology
- Cardiovascular Science
- Menopause Research
Background:
- Menopausal hot flashes are a common symptom impacting women's health.
- Conflicting data exists regarding cardiovascular disease (CVD) risk in hormone therapy (HT) studies.
- Vascular function may be affected by hot flashes, potentially explaining discrepancies in HT research.
Purpose of the Study:
- To investigate the relationship between hot flash status and CVD risk factors in recently postmenopausal women.
- To assess if hot flashes correlate with specific biochemical vascular surrogate markers.
Main Methods:
- Prospective study of 150 healthy, nonsmoking women with recent menopause onset (0.5-3 years).
- Categorized women based on hot flash severity (none, mild, moderate, severe).
- Laboratory tests included lipids, lipoproteins, apolipoproteins, high-sensitivity C-reactive protein, and sex hormone-binding globulin.
Main Results:
- No significant differences in lipid profiles (total cholesterol, LDL, HDL, triglycerides) or apolipoproteins were found between hot flash groups.
- Levels of sex hormone-binding globulin and high-sensitivity C-reactive protein showed a negative correlation but were independent of hot flash severity.
- Estrone, estradiol, and free estradiol index levels were comparable across all groups.
Conclusions:
- No baseline differences in lipid or non-lipid CVD risk factors were observed between women with and without significant hot flashes.
- Hot flash status itself may not be the confounding factor explaining differing results between observational and randomized HT trials.
Objective:
Menopausal hot flashes may affect vascular function and perhaps explain conflicting data on cardiovascular disease (CVD) between observational and randomized hormone therapy (HT) studies. We prospectively assessed hot flash status in recently postmenopausal women and related it to a number of biochemical vascular surrogate markers for CVD.
Methods:
Healthy, nonsmoking women (n = 150) exhibiting a broad range (no, mild, moderate, severe) of hot flashes and an onset of menopause within the previous 0.5 to 3 years were studied with laboratory tests for lipids, lipoproteins, apolipoproteins, high-sensitivity C-reactive protein, and sex hormone-binding globulin.
Results:
Apart from marked differences in hot flashes, the groups showed comparable levels of estrone, estradiol, or free estradiol index. The levels of total cholesterol (3.7-9.1 mmol/L) were similar between the groups (P = 0.744), and hypercholesterolemia (>6.5 mmol/L) was encountered equally often (P = 0.699). No difference was seen in high-, low-, or very low-density lipoproteins, triglycerides, apolipoprotein A-1, apolipoprotein B (or their ratio), or lipoprotein(a) between the groups. The levels of sex hormone-binding globulin and high-sensitivity C-reactive protein correlated negatively with each other (r = -0.204; P = 0.013) but showed no dependence on hot flashes (P = 0.531 and P = 0.215, respectively).
Conclusions:
No baseline difference in lipid or nonlipid CVD risk factors was observed between women with hot flashes (potential HT users) and women with no or mild hot flashes (potential HT nonusers). This may imply that hot flash status per se cannot explain the difference between observational and randomized trials.
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