Greater state anxiety was associated with higher sympathetic activity (PEP β = -0.24, P=0.02), while greater trait anxiety and depressive symptoms correlated with lower parasympathetic activity.
Observational (n=121)
Are anxiety and depressive symptoms associated with an adverse cardiac autonomic profile in perimenopausal and postmenopausal women with hot flashes?
Increased anxiety and depressive symptoms in midlife women with hot flashes are associated with an unfavorable cardiac autonomic profile, potentially increasing cardiovascular risk.
Effect estimate: β = -0.24
p-value: p=0.02
OBJECTIVE: The aim of the study was to examine whether anxiety and depressive symptoms are associated with an adverse cardiac autonomic profile among midlife women with hot flashes. METHODS: Anxiety and depressive symptoms were evaluated by validated self-administered questionnaires among peri- and postmenopausal women in a randomized trial of slow-paced respiration for hot flashes. Pre-ejection period (PEP), a marker of sympathetic activation, and respiratory sinus arrhythmia (RSA), a marker of parasympathetic activation, were measured at baseline and 12 weeks using impedance cardiography and electocardiography. Multivariable repeated measures linear regression models examined associations between anxiety and depression symptoms and autonomic markers, corrected for multiple comparisons with Benjamini-Hochberg procedure, and adjusted for age and body mass index. RESULTS: Among the 121 participants, greater state anxiety was associated with shorter PEP, reflecting higher sympathetic activity (β = -0.24, P = 0.02). Greater trait anxiety and cognitive anxiety were associated with lower RSA, reflecting decreased parasympathetic activity (β = -0.03, P < 0.01 for Spielberger Trait Anxiety; β = -0.06, P = 0.02 for Hospital Anxiety and Depression Scale HADS Anxiety Subscale). Greater depressive symptoms were associated with lower RSA (β = -0.06, P = 0.03 for HADS Depression Subscale; β = -0.03, P = 0.04 for Beck Depression Inventory). CONCLUSIONS: Among peri- and postmenopausal women with hot flashes, greater self-reported anxiety and depressive symptoms were associated with lower levels of resting cardiac parasympathetic activity, and greater state anxiety was associated with higher levels of cardiac sympathetic activity. Findings suggest that midlife women with increased anxiety and depressive symptoms may have an unfavorable cardiac autonomic profile with potential implications for their overall cardiovascular risk.
Fu et al. (Tue,) conducted a observational in Perimenopausal and postmenopausal women with hot flashes (n=121). Anxiety and depressive symptoms was evaluated on Pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) (β = -0.24, p=0.02). Greater state anxiety was associated with higher sympathetic activity (PEP β = -0.24, P=0.02), while greater trait anxiety and depressive symptoms correlated with lower parasympathetic activity.