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Menopausal hot flashing and endothelial function in two vascular beds: findings from a cross-sectional study of

Stamatina Iliodromiti1, Naveed Sattar2, Christian Delles2

  • 1Women's Health Research Division, Blizard Institute, Queen Mary University London, London, United Kingdom.

Menopause (New York, N.Y.)
|August 28, 2019
PubMed

Insights

Menopausal hot flashes are linked to increased insulin resistance and reduced macrovascular function in postmenopausal women. Microvascular responses were paradoxically enhanced, suggesting non-endothelial mechanisms.

Area of Science:

  • Cardiovascular physiology
  • Menopause research
  • Vascular biology

Background:

  • Menopausal hot flashes are common and may signal underlying cardiovascular disease (CVD) risk.
  • Vascular reactivity assessment provides insights into endothelial function and CVD risk.

Purpose of the Study:

  • To investigate the association between menopausal hot flashes and vascular reactivity in microvascular and macrovascular beds.
  • To explore the relationship between hot flashing and cardiovascular disease risk profile in postmenopausal women.

Main Methods:

  • Cross-sectional study of 79 postmenopausal women (23 non-flashers, 56 flashers).
  • Microvascular reactivity assessed using Laser Doppler Imaging with Iontophoresis (acetylcholine and sodium-nitroprusside).
  • Macrovascular endothelial function measured by Reactive Hyperemia Index (RHI); insulin sensitivity assessed.

Main Results:

  • Women with hot flashes showed enhanced microvascular responses to acetylcholine (~30%) and sodium-nitroprusside (~31%).
  • Hot flash group exhibited lower RHI (~13%), indicating impaired macrovascular function.
  • Hot flashers were more insulin resistant (HOMAIR: 1.9 vs 1.4, P=0.03).

Conclusions:

  • Hot flashing is associated with greater insulin resistance and reduced macrovascular response.
  • Enhanced microvascular reactivity in flashers may involve thermoregulatory pathways, not solely endothelial integrity.
Abstract

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