Vasomotor symptoms and coronary artery calcium in postmenopausal women.
OBJECTIVE
We assessed whether vasomotor symptoms (VMS) are associated with coronary artery calcium (CAC) and how hormone therapy (HT) may influence this association.


METHODS
Participants were a subset of women aged 50 to 59 years with a history of hysterectomy who were enrolled in the Women's Health Initiative (WHI) estrogen-alone clinical trial and underwent a CT scan of the chest at the end of the trial to determine CAC. Participants provided information about VMS (hot flashes and/or night sweats), as well as HT use, on self-administered questionnaires at trial baseline.


RESULTS
The sample consisted of 918 women with a mean (SD) age of 55.1 (2.8) years at WHI randomization and 64.8 (2.9) years at CAC ascertainment. The prevalence of a CAC score higher than 0 was 46%, whereas the prevalence of a CAC score of 10 or higher and higher than 100 was 39% and 19%, respectively. At randomization, 77% reported a history of any VMS at any time before or at enrollment in the WHI, whereas 20% reported any VMS present only at enrollment. Compared with those without a history of any VMS and after adjustment for potential confounders, a history of any VMS at any time up to and including WHI enrollment was associated with significantly reduced odds for CAC higher than 0 (odds ratio, 0.66; 95% CI, 0.45-0.98). Moreover, as duration of HT increased, the inverse association between any VMS and CAC moved toward the null.


CONCLUSIONS
A history of any VMS was significantly associated with reduced odds for CAC independent of traditional cardiovascular disease risk factors and other relevant covariates. This association seems to be influenced by duration of HT.
Allison
Matthew A
MA
University of California San Diego, La Jolla, CA 92093-0965, USA. mallison@ucsd.edu
Manson
Joann E
JE
Aragaki
Aaron
A
Langer
Robert D
RD
Rossouw
Jacques
J
Curb
David
D
Martin
Lisa W
LW
Phillips
Lawrence
L
Stefanick
Marcia L
ML
Cochrane
Barbara B
BB
Sarto
Gloria
G
Barnhart
Janice
J
O'Sullivan
Mary Jo
MJ
Johnson
Karen C
KC
Gass
Margery
M
Trevisan
Maurizio
M
Woods
Nancy F
NF
D002118:Calcium / Q000097:blood*; D003331:Coronary Vessels / Q000378:metabolism / Q000473:pathology*; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D019584:Hot Flashes / Q000503:physiopathology; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D017698:Postmenopause / Q000502:physiology*; D011795:Surveys and Questionnaires; D013546:Sweating / Q000502:physiology; D014057:Tomography, X-Ray Computed; D014666:Vasomotor System / Q000187:drug effects / Q000503:physiopathology*
D002118:Calcium