Timing of menopause symptoms relates to risk markers for heart disease, stroke

"Our study provides reassurance that the common experience of menopausal symptoms in early menopause is not associated with increases in blood pressure or other risk markers for cardiovascular disease," said lead researcher Emily Szmuilowicz, MD, an assistant professor at Northwestern University's medical school in Chicago.

Researchers have questioned whether vasomotor menopausal symptoms such as hot flashes and night sweats reflect poor cardiovascular health. However, a 2011 study by Szmuilowicz and co-workers found that women who experienced menopausal symptoms only at the onset of menopause were less likely to have a stroke or heart attack or to die than were women who experienced hot flashes late in menopause or who did not have hot flashes at all.

Their new study focused on markers in the body that have been linked to a raised risk of cardiovascular disease. The risk markers examined were blood pressure, cholesterol, insulin, glucose (blood sugar) and blood markers of abnormal blood vessel function. Because inflammation is common in people with heart disease or stroke, the group also looked at blood markers of inflammation, including white blood cell count—the number of disease-fighting cells.

This study used retrospective data from nearly 60,000 postmenopausal women who participated in the Women's Health Initiative Observational Study. The ongoing study, funded by the National Institutes of Health, is examining the relationships between health outcomes and new risk indicators for disease.

The researchers grouped women into four categories based on timing of their menopausal symptoms of hot flashes and night sweats: only at the start of menopause (early-onset menopausal symptoms), only years later in menopause (late-onset menopausal symptoms), both time periods (persistent menopausal symptoms), and not at all.

The investigators found no association between early-onset vasomotor menopausal symptoms and increased levels of any cardiovascular risk markers. However, both persistent and late-onset menopausal symptoms were associated with higher blood pressure and higher white blood cell count compared with women without menopausal symptoms, they reported. Persistent menopausal symptoms also correlated with higher levels of glucose and insulin, which are markers for diabetes.

It is unclear why women who experience menopausal symptoms at different stages of menopause may have differing levels of cardiovascular disease risk, Szmuilowicz said She speculated that "if menopausal symptoms occur long after menopause begins, this may signal a blood vessel abnormality that could also affect cardiovascular health."

Provided by The Endocrine Society