North American Menopause Society

North American Menopause Society

October 05, 2015
2 min read

Severity of hot flashes associated with subclinical CVD

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Women reporting more frequent, severe and bothersome hot flashes are more likely to have increased carotid intima-media thickness, thereby elevating their risk for cardiovascular events, according to recent study findings presented at The North American Menopause Society Annual Meeting.

Rebecca C. Thurston, PhD, of the University of Pittsburgh, and colleagues analyzed data from 255 nonsmoking women aged 40 to 60 years (mean age, 54 years; 71% white; mean BMI, 29 kg/m²; 83% postmenopausal) with no history of clinical CVD. Within the cohort, 134 reported having daily hot flashes; 121 reported no current hot flashes. Women prescribed beta-blockers, calcium channel blockers, insulin or medications known to affect hot flashes were excluded from the study.

Rebecca Thurston

Rebecca C. Thurston

The women were provided electronic diaries to record 3 days of hot flash symptoms; women self-reported the frequency, severity and “bother” associated with hot flashes. Women also underwent 24 hours of physiologic hot flash monitoring and carotid ultrasound to assess carotid intima-media thickness (IMT). Lipid profile and glucose, insulin and estradiol levels were measured with blood samples.

Researchers found that 57 of the 121 women who reported no hot flashes showed physiologic hot flashes after ambulatory monitoring. After adjusting for CVD risk factors, a higher frequency of waking, physiologically assessed hot flashes, particularly among women showing symptoms, was associated with higher mean IMT (P = .004) and maximal IMT (P = .003), as well as individual segments bulb IMT (P = .009) and internal carotid artery IMT (P = .03). Findings remained significant after adjusting for estradiol level and menopausal stage. Women who self-reported more severe and bothersome hot flashes in electronic diaries also had a higher mean IMT in multivariable models, according to researchers.

Neither traditional CVD risk factors nor endogenous estradiol accounted for these associations, according to the researchers.

“Providers should be vigilant to women who have a high burden of hot flashes,” Thurston told Endocrine Today. “For these women, providers should be on top of their [CV] health using standard pharmacologic and behavioral means. Moving forward, we need to understand whether hot flashes are a marker of, a consequence of, or somehow etiologically involved in [CVD] in women. We also do not yet know whether treating hot flashes will impact women’s [CV] health.” – by Regina Schaffer


Thurston RC, et al. S-12. Presented at: The North American Menopause Society Annual Meeting; Sept. 30-Oct. 3, 2015; Las Vegas.

Disclosure: Thurston reports no relevant financial disclosures.