Hot flashes and carotid intima media thickness among midlife women.
OBJECTIVE
Emerging evidence suggests associations between menopausal hot flashes and cardiovascular risk. However, whether hot flashes are associated with intima media thickness (IMT) or IMT changes over time is unknown. We hypothesized that reported hot flashes would be associated with greater IMT cross-sectionally and with greater IMT progression over 2 years.


METHODS
Participants were 432 women aged 45 to 58 years at baseline participating in the Study of Women's Health Across the Nation (SWAN) Heart, an ancillary study to the SWAN. Measures at the SWAN Heart baseline and follow-up visit 2 years later included a carotid artery ultrasound, reported hot flashes (past 2 weeks: none, 1-5 d, ≥6 d), and a blood sample for measurement of estradiol.


RESULTS
Women reporting hot flashes for 6 days or more in the prior 2 weeks had significantly higher IMT than did women without hot flashes at the baseline (mean [SE] difference, 0.02 [0.01] mm; P=0.03) and follow-up (mean [SE] difference, 0.02 [0.01] mm; P=0.04) visits, controlling for demographic factors and cardiovascular risk factors. Reporting hot flashes at both study visits was associated with higher follow-up IMT relative to reporting hot flashes at neither visit (mean [SE] difference, 0.03 [0.01] mm; P=0.03). Associations between hot flashes and IMT largely remained after adjusting for estradiol. An interaction between hot flashes and obesity status was observed (P=0.05) such that relations between hot flashes and IMT were observed principally among overweight/obese women. Hot flashes were not associated with IMT progression.


CONCLUSIONS
These findings provide some indication that women reporting hot flashes for 6 days or more in the prior 2 weeks may have higher IMT than do women without hot flashes, particularly for women who are overweight or obese. Further work should determine whether hot flashes mark adverse underlying vascular changes.
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. thurstonrc@upmc.edu
Rebecca C
RC
Thurston
Kim
K
Sutton-Tyrrell
Susan A
SA
Everson-Rose
Rachel
R
Hess
Lynda H
LH
Powell
Karen A
KA
Matthews
D050197:Atherosclerosis / Q000209:etiology* / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D019584:Hot Flashes / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014666:Vasomotor System; D016387:Women's Health
D004958:Estradiol
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