Hypertensive pregnancy disease increased vasomotor symptoms in menopause

Drost JT. Menopause. 2013;doi:10.1097/GME.0b013e3182886093.

  • April 9, 2013

New data from researchers in the Netherlands demonstrate that women with hypertensive pregnancy diseases reported more frequent vasomotor symptoms compared with those without hypertensive diseases during pregnancy.

To investigate the potential link between history of hypertensive pregnancy diseases and vasomotor symptoms, José T. Drost, MD, of the department of cardiology at Isala Klinieken in Zwolle, the Netherlands, and colleagues examined 853 women (aged 40 to 70 years) who visited an outpatient cardiovascular clinic for women in Kampen (Zwolle area) between 2003 and 2010.

Each patient completed a questionnaire on their history of hypertensive pregnancy disease, demographic characteristics and vasomotor symptoms. They also underwent examinations and blood tests.

Results from the questionnaire revealed that 274 women (32%) reported a history of hypertensive pregnancy disease; 83% of whom reported vasomotor symptoms. Among those without a history of hypertensive pregnancy disease, 75% reported vasomotor symptoms.

Further data indicate vasomotor symptoms were present more often (OR=1.62; 95% CI, 1-2.63) and persisted for longer than 1 year more frequently (OR=2.05; 95% CI, 1.08-3.89) among women with a history of hypertensive pregnancy disease compared with women without. These vasomotor symptoms were severe in women with a history of hypertensive pregnancy disease more often. However, this was not statistically significant (adjusted OR=1.28; 95% CI, 0.92-1.80), the researchers wrote.

“In this study, we found that vasomotor symptoms during menopause occur more often in middle-aged women with a history of hypertensive disease in pregnancy (at our ‘Kampen women cardiology clinic’) than in women with a history of normotensive pregnancies,” Drost and colleagues wrote.

They recommend observational research to examine the consistency of these associations and to determine the underlying pathophysiology mechanisms between hypertensive pregnancy disease and vasomotor symptoms.

Disclosure: The researchers report no relevant financial disclosures.

Perspective
Michelle P. Warren, MD, NCMP

Michelle P. Warren

  • This is an interesting association between the development of hypertension in pregnancy and later vasomotor symptoms (VMS) in menopause, both predictors of future cardiovascular disease. Women who had this pregnancy history had a small increase in the incidence of VMS over those who did not. In addition, these symptoms were more severe and lasted more than a year. The overall incidence in this Dutch study of hypertension in pregnancy was fairly high (30%) but this may be due to the fact that the study was done in a clinic where half of the referrals were for cardiac symptoms. Also, the patients who had a positive history had more risk factors including higher BMI and abdominal adiposity but adjusting for these confounders did not affect the association. This study suggests that there may be common pathophysiological mechanisms to both conditions.

    • Michelle P. Warren, MD
    • Endocrine Today Editorial Board Member
      Medical director for the Center for Menopause, Hormonal Disorders and Women’s Health
      Professor of medicine and obstetrics and gynecology and Wyeth professor of women’s health
      College of Physicians and Surgeons at New York Presbyterian Hospital/Columbia University Medical Center
  • Disclosures: Warren reports no relevant financial disclosures.

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