Vasomotor symptoms and mortality

OBJECTIVE: The purpose of this study was to examine the associations of vasomotor symptoms with risk of all-cause, cardiovascular disease (CVD), and coronary heart disease (CHD) mortality in community-dwelling older women, with a mean age of 69 years. METHODS: This prospective population-based study included 867 postmenopausal women who provided lifestyle and menopause-related history at the 1984 to 1987 visit of the Rancho Bernardo Study and answered a 1989 mailed questionnaire on menopause and vasomotor symptoms. Ninety-eight percent were followed for vital status through July 2004. RESULTS: Overall, 73% reported hot flashes, of whom 39% also reported night sweats. During the 11.5-year average follow-up, there were 405 deaths, of which 194 were attributed to CVD and 71 to CHD. Hot flashes alone were not associated with all-cause mortality, but women who, in addition to hot flashes, also had night sweats had an almost 30% (hazard ratio [HR], 0.72; 95% CI, 0.55-0.94) lower all-cause mortality risk compared with women without this symptom, independent of body mass index, past or current use of estrogen or progestin, physical exercise, and smoking habit. There was a similar lower risk of CVD and CHD mortality in women with night sweats when adjusted for past or current use of estrogen or progestin (HR, 0.62; 95% CI, 0.42-0.92 and HR, 0.51; 95% CI, 0.26-0.99, respectively). These associations were independent of hormone use but were no longer significant after adjusting for body mass index, physical exercise, and smoking. CONCLUSIONS: Reported night sweats at menopause are associated with reduced risk of death over the following 20 years, independent of multiple risk factors including past or current use of postmenopausal estrogen therapy.