title: Evidence for a role of hot flushes in vascular function in recently postmenopausal women.
abstract: OBJECTIVE
  Observational studies indicate that postmenopausal hormone therapy (HT) prevents cardiovascular disease, but randomized clinical trials have not confirmed this effect. Hot flushes were more likely to be present in women starting HT in observational studies, whereas these symptoms were mild or absent among women attending randomized clinical trials. We hypothesized that vascular function may differ in women with and without vasomotor hot flushes.
  
  
  METHODS
  One hundred forty-three recently postmenopausal women showing a broad range of variation in hot flushes were studied with radial artery tonometry. Pulse wave analyses were assessed at baseline and after nitroglycerin and salbutamol challenges. Wilcoxon signed rank test was used for paired comparisons after challenges with nitroglycerin and salbutamol.
  
  
  RESULTS
  Neither baseline arterial stiffness nor endothelial function differed between women without or with mild, moderate, or severe hot flushes. However, after nitroglycerin challenge, the time to the onset of the reflected wave (dependent on pulse wave velocity) was 9.5% longer (P=.014), and the time to the first systolic peak (dependent on the rapid phase of ventricular ejection) was 13.9% longer (P=.025) in women with severe hot flushes as compared with asymptomatic women.
  
  
  CONCLUSIONS
  Women with severe vasomotor hot flushes show greater vascular responsiveness to nitroglycerin than women without hot flushes. This may partially explain the conflicting data between observational and randomized HT studies.
  
  
  BACKGROUND
  ClinicalTrials.gov, www.clinicaltrials.gov, NCT00668603
  
  
  METHODS
  II.
authors.affiliation: From the Department of Obstetrics and Gynecology, Helsinki University Central Hospital; Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki; Division of Nephrology, Department of Medicine, Helsinki University Central Hospital; and Division of Clinical Physiology and Nuclear Medicine, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Pauliina
authors.initials: P
authors.lastname: Tuomikoski
authors.forename: Pia
authors.initials: P
authors.lastname: Ebert
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
authors.forename: Petri
authors.initials: P
authors.lastname: Haapalahti
authors.forename: Hanna
authors.initials: H
authors.lastname: Hautamäki
authors.forename: Mats
authors.initials: M
authors.lastname: Rönnback
authors.forename: Olavi
authors.initials: O
authors.lastname: Ylikorkala
authors.forename: Tomi S
authors.initials: TS
authors.lastname: Mikkola
mesh_terms: D000420:Albuterol / Q000494:pharmacology; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology / Q000503:physiopathology; D005260:Female; D019584:Hot Flashes / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D005996:Nitroglycerin / Q000494:pharmacology; D017698:Postmenopause; D017534:Radial Artery / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014665:Vasodilator Agents / Q000494:pharmacology*; D014666:Vasomotor System / Q000187:drug effects* / Q000502:physiology / Q000503:physiopathology
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin; D000420:Albuterol