Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA.
Menopause. 2018 Nov;25(11):1354-1361. doi: 10.1097/GME.0000000000001239.
Hot flashes are experienced by most midlife women. Emerging data indicate that they may be associated with endothelial dysfunction. No studies have tested whether hot flashes are associated with endothelial function using physiologic measures of hot flashes. We tested whether physiologically assessed hot flashes were associated with poorer endothelial function. We also considered whether age modified associations.
Two hundred seventy-two nonsmoking women reporting either daily hot flashes or no hot flashes, aged 40 to 60 years, and free of clinical cardiovascular disease, underwent ambulatory physiologic hot flash and diary hot flash monitoring; a blood draw; and ultrasound measurement of brachial artery flow-mediated dilation to assess endothelial function. Associations between hot flashes and flow-mediated dilation were tested in linear regression models controlling for lumen diameter, demographics, cardiovascular disease risk factors, and estradiol.
In multivariable models incorporating cardiovascular disease risk factors, significant interactions by age (P < 0.05) indicated that among the younger tertile of women in the sample (age 40-53 years), the presence of hot flashes (beta [standard error] = -2.07 [0.79], P = 0.01), and more frequent physiologic hot flashes (for each hot flash: beta [standard error] = -0.10 [0.05], P = 0.03, multivariable) were associated with lower flow-mediated dilation. Associations were not accounted for by estradiol. Associations were not observed among the older women (age 54-60 years) or for self-reported hot flash frequency, severity, or bother. Among the younger women, hot flashes explained more variance in flow-mediated dilation than standard cardiovascular disease risk factors or estradiol.
Among younger midlife women, frequent hot flashes were associated with poorer endothelial function and may provide information about women's vascular status beyond cardiovascular disease risk factors and estradiol.
大多数中年女性都会经历热潮。新出现的数据表明，它们可能与血管内皮功能障碍有关。尚无研究测试热潮是否与使用生理测量的热潮有关。我们测试了生理评估的热潮是否与内皮功能较差有关。我们还考虑了年龄是否会改变关联。
272 名不吸烟的女性报告每天有热潮或没有热潮，年龄在 40 至 60 岁之间，无临床心血管疾病，进行了动态生理热潮和日记热潮监测；血液采集；以及超声测量肱动脉血流介导的扩张，以评估内皮功能。在控制管腔直径、人口统计学、心血管疾病危险因素和雌二醇的线性回归模型中测试了热潮与血流介导扩张之间的关联。
在纳入心血管疾病危险因素的多变量模型中，年龄的显著交互作用（P<0.05）表明，在样本中年龄较小的三分之一女性（年龄 40-53 岁）中，存在热潮（β[标准误差] =-2.07[0.79]，P=0.01）和更频繁的生理热潮（每次热潮：β[标准误差] =-0.10[0.05]，P=0.03，多变量）与较低的血流介导扩张有关。这些关联与雌二醇无关。在年龄较大的女性（年龄 54-60 岁）或自我报告的热潮频率、严重程度或困扰程度中未观察到关联。在较年轻的女性中，热潮解释了血流介导扩张的更多变化，而不仅仅是心血管疾病危险因素或雌二醇。
在较年轻的中年女性中，频繁的热潮与内皮功能较差有关，并且可能提供有关女性血管状况的信息，超出了心血管疾病危险因素和雌二醇的范围。
