Association Between Vasomotor Symptoms and Ischemic Stroke: A Case-Control Study

Ischemic stroke (IS) represents the most prevalent subtype of cerebrovascular disease. Although vasomotor symptoms (VMS) have been linked to cardiovascular disease (CVD), their association with specific stroke subtypes remains unclear.

This multicenter case-control study included 358 postmenopausal women, consisting of 179 patients with IS and 179 age-matched controls. Participants were assessed for VMS frequency and severity, lifestyle behaviors, and established vascular risk factors. Stroke severity was measured using the National Institutes of Health Stroke Scale (NIHSS).

Patients with IS exhibited a higher prevalence of VMS during the perimenopause (p < 0.001) and in the past week (p = 0.001) compared to controls. IS patients also reported more frequent VMS during both the perimenopausal period (p = 0.001) and the past week (p = 0.014). After multivariable adjustments, both perimenopausal VMS (OR: 2.16, 95% CI: 1.42-3.30, p  <  0.001) and the past week VMS (OR: 2.06, 95% CI: 1.33-3.26, p = 0.001) remained independently associated with IS. Correlation analysis within the patient group showed no correlation between NIHSS scores and either the modified Kupperman index or the hot flush rating scale scores (p > 0.05). The area under the ROC curve for perimenopausal and recent hot flashes was 0.809 (p < 0.001), indicating substantial predictive value.

VMS independently predicts the risk of IS. Women who experience frequent VMS should undergo targeted surveillance and early preventive strategies.