心悸与中年女性血管舒缩症状和焦虑的独立相关性。

Independent association of palpitation with vasomotor symptoms and anxiety in middle-aged women.

机构信息

Department of Obstetrics and Gynecology, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Women's Health, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Menopause. 2021 May 24;28(7):741-747. doi: 10.1097/GME.0000000000001776.

DOI:10.1097/GME.0000000000001776

PMID:34033601

Abstract

OBJECTIVE

Palpitation, or the sensation of rapid or irregular heartbeats, is common in menopausal women; however, the precise underlying mechanisms are unknown. We aimed to investigate factors associated with palpitation in middle-aged women.

METHODS

Medical records of 394 women aged 40 to 59 years (108 premenopausal, 85 perimenopausal, and 201 postmenopausal) were analyzed cross-sectionally. Palpitation severity was estimated based on responses to the Menopausal Symptom Scale. Effects of background characteristics, including age, menopausal status, body composition, cardiovascular parameters, basal metabolism, physical fitness, lifestyle factors, vasomotor, and psychological symptoms on palpitation were assessed using multivariate logistic regression analysis. The association between autonomic nervous system activity and palpitation was also analyzed in 198 participants.

RESULTS

Prevalence of palpitation by severity was as follows: none, 26.4%; mild, 32.7%; moderate, 29.4%; severe, 11.4%. In univariate analyses, the more severely the women were affected by palpitation, 1) the higher their systolic blood pressure, 2) the less exercise they performed, 3) the lower they scored in the sit-and-reach test, 4) the higher their vasomotor symptoms score in the Menopausal Health Related-Quality of Life questionnaire, and 5) the higher their Hospital Anxiety and Depression Scale. Multiple logistic regression analysis revealed that moderate to severe palpitation was independently associated with the vasomotor symptom score (adjusted odds ratio [95% confidence interval]: 1.18 [1.07-1.31]) and Hospital Anxiety and Depression Scale anxiety subscale score (1.19 [1.12-1.27]).

CONCLUSIONS

Rapid or irregular heartbeats are highly prevalent in middle-aged women. It is not associated with age, menopausal status, heart rate, arrhythmia, autonomic nervous system activity, caffeine, or alcohol consumption, but with vasomotor symptoms and anxiety.

摘要

目的

心悸，即心跳过快或不规则的感觉，在更年期妇女中很常见；然而，确切的潜在机制尚不清楚。我们旨在研究与中年女性心悸相关的因素。

方法

对 394 名年龄在 40 至 59 岁的女性（108 名绝经前、85 名围绝经期和 201 名绝经后）的病历进行了横断面分析。根据绝经症状量表的回答来评估心悸的严重程度。使用多变量逻辑回归分析评估了背景特征（包括年龄、绝经状态、身体成分、心血管参数、基础代谢、体能、生活方式因素、血管舒缩和心理症状）对心悸的影响。还在 198 名参与者中分析了自主神经系统活动与心悸之间的关系。

结果

按严重程度划分的心悸发生率如下：无，26.4%；轻度，32.7%；中度，29.4%；重度，11.4%。在单因素分析中，女性心悸越严重，1）收缩压越高，2）运动越少，3）坐立伸展测试得分越低，4）绝经健康相关生活质量问卷中的血管舒缩症状评分越高，5）医院焦虑抑郁量表评分越高。多变量逻辑回归分析显示，中度至重度心悸与血管舒缩症状评分（调整后的优势比[95%置信区间]：1.18[1.07-1.31]）和医院焦虑抑郁量表焦虑分量表评分（1.19[1.12-1.27]）独立相关。