Zhao Emily L, Gibson Carolyn J, Raghunathan Harini, Schembri Michael, Ganz Peter, Huang Alison J
School of Medicine, Case Western Reserve University, Cleveland, OH.
San Francisco Veterans Affairs Health Care System, San Francisco, CA.
Menopause. 2025 Aug 1;32(8):702-709. doi: 10.1097/GME.0000000000002556.
To evaluate prospective changes in psychological function among menopausal women using continuous nitroglycerin for hot flashes and examine repeated associations between psychological symptoms and hot flashes.
Menopausal women with ≥7 hot flashes/day were randomized to continuous transdermal nitroglycerin (0.2-0.4 mg/h) or placebo for 12 weeks. Psychological function was evaluated using the Center for Epidemiologic Studies-Depression Scale (CES-D), Generalized Anxiety Disorders-7 (GAD-7), and Menopause-Specific Quality of Life (MENQOL) Psychosocial Subscale. Linear mixed models examined treatment effects on mood symptoms from baseline to 5 and 12 weeks. Based on validated 7-day hot flash diaries, additional models examined associations between mood symptoms and hot flash frequency in both groups combined.
Among the 141 randomized participants (mean 10.8±3.5 hot flashes/day), nitroglycerin therapy did not improve CES-D or GAD-7 scores (prespecified secondary outcomes) from baseline to 5 and 12 weeks compared with placebo. Greater hot flash frequency was associated with worse GAD-7 scores across all timepoints (β=0.05 per 1 hot flash, P =0.005), but no associations between hot flashes and CES-D or MENQOL Psychosocial scores were observed. Improvement in hot flash frequency was associated with improvement in MENQOL Psychosocial score (β=0.04 per 1 hot flash, P =0.03), but no associations between improvements in hot flashes and improvements in GAD-7 or CES-D scores were detected.
In a randomized trial of continuous nitroglycerin, improvements in hot flash frequency did not consistently translate into improvements in mood. Clinicians caring for women with overlapping hot flashes and mood symptoms should consider other factors influencing midlife psychological function.
评估使用持续硝酸甘油治疗潮热的绝经后女性心理功能的前瞻性变化，并研究心理症状与潮热之间的反复关联。
潮热发作频率≥7次/天的绝经后女性被随机分为两组，分别接受持续经皮硝酸甘油（0.2 - 0.4毫克/小时）或安慰剂治疗，为期12周。使用流行病学研究中心抑郁量表（CES - D）、广泛性焦虑症量表 - 7（GAD - 7）和更年期特异性生活质量量表（MENQOL）心理社会子量表评估心理功能。线性混合模型用于研究从基线到第5周和第12周治疗对情绪症状的影响。基于经过验证的7天潮热日记，另外的模型研究了两组合并后情绪症状与潮热频率之间的关联。
在141名随机参与者中（平均潮热发作频率为10.8±3.5次/天），与安慰剂相比，从基线到第5周和第12周，硝酸甘油治疗并未改善CES - D或GAD - 7评分（预先设定的次要结局）。在所有时间点，潮热发作频率越高，GAD - 7评分越差（每增加1次潮热，β = 0.05，P = 0.005），但未观察到潮热与CES - D或MENQOL心理社会评分之间的关联。潮热发作频率的改善与MENQOL心理社会评分的改善相关（每增加1次潮热，β = 0.04，P = 0.03），但未检测到潮热改善与GAD - 7或CES - D评分改善之间的关联。
在持续硝酸甘油的随机试验中，潮热发作频率的改善并未始终转化为情绪改善。照顾同时有潮热和情绪症状的女性的临床医生应考虑影响中年心理功能的其他因素。
