Key result
Menopausal hot flashes were associated with a ~30% enhanced microvascular response to acetylcholine (P=0.04) and a ~13% lower macrovascular Reactive Hyperemia Index (P=0.05) compared to no flashes.
Why the study?
To examine the association of menopausal hot flashing with vascular reactivity in two different vascular beds and explore its relationship with cardiovascular disease risk profiles.
Is menopausal hot flashing associated with altered endothelial function and cardiovascular disease risk profile in healthy postmenopausal women?
Cross-Sectional (n=79)
Is menopausal hot flashing associated with altered endothelial function and cardiovascular disease risk profile in healthy postmenopausal women?
Menopausal hot flashes are associated with greater insulin resistance and lower macrovascular endothelial function, suggesting a potential link to increased cardiovascular risk.
Hot flashes linked to divergent endothelial responses across vascular beds; leaves open causal links and clinical relevance in postmenopausal CVD risk.
OBJECTIVE: We sought to examine the association of menopausal hot flashing with vascular reactivity in two different vascular beds in the same cohort of postmenopausal women and explore the relationship between hot flashing and cardiovascular disease (CVD) risk profile. METHODS: A cross-sectional study of 79 healthy postmenopausal women, 23 of whom have never had menopausal hot flashes and 56 of whom have reported hot flashes. Endothelial function at a microvascular level was measured with Laser Doppler Imaging with Iontophoresis which assesses the response to both acetylcholine (Ach, endothelium dependent) and sodium-nitroprusside (SNP, endothelium independent). Reactive Hyperemia Index (RHI) was measured with peripheral arterial tonometry as a marker of endothelial function mainly at a macrovascular level. Metabolic biomarkers including insulin sensitivity were assessed. RESULTS: Women with hot flashes had enhanced microvascular response to Ach by ∼30% (P = 0.04) and to SNP by ∼31% (P = 0.02), but lower RHI by ∼13% (P = 0.05) compared with women without flashes. Hot flashing was associated with enhanced response to SNP and lower RHI after adjustment for confounders and conventional CVD risk factors. Women with hot flashes were more insulin resistant than nonflashers (HOMAIR: 1.9 (1.2-2.6) vs 1.4 (0.8-1.9), P = 0.03). CONCLUSIONS: Our data support the association of hot flashing with greater insulin resistance and lower macrovascular response. The paradoxical enhanced microvascular response in hot flashers could be the result of the net effect of thermoregulatory and nonnitric oxide-related pathways rather than of endothelial integrity.
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Iliodromiti et al. (2019) conducted a cross-sectional in Healthy postmenopausal women (n=79). Menopausal hot flashes vs. No menopausal hot flashes was evaluated on Endothelial function (microvascular response to acetylcholine and sodium-nitroprusside, and macrovascular Reactive Hyperemia Index) (p=0.04 for Ach, 0.02 for SNP, 0.05 for RHI). Menopausal hot flashes were associated with a ~30% enhanced microvascular response to acetylcholine (P=0.04) and a ~13% lower macrovascular Reactive Hyperemia Index (P=0.05) compared to no flashes.
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