Zhu, D;
Chung, H-F;
Dobson, AJ;
Pandeya, N;
Anderson, DJ;
Kuh, D;
Hardy, R;
... Mishra, GD; + view all
(2020)
Vasomotor menopausal symptoms and risk of cardiovascular disease: a pooled analysis of six prospective studies.
American Journal of Obstetrics and Gynecology
, 223
(6)
898.e1-898.e16.
10.1016/j.ajog.2020.06.039.
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Abstract
Background: Menopausal vasomotor symptoms (VMS, i.e., hot flushes and night sweats) have been associated with unfavorable risk factors and surrogate markers of cardiovascular disease (CVD), but their association with clinical CVD events is unclear. We aimed to examine the associations between different component of VMS and timing of VMS and risk of CVD. / Study Design: We harmonized and pooled individual-level data from 23 365 women in six prospective studies which contributed to the InterLACE consortium. Women who experienced CVD events before baseline were excluded. The associations between frequency (never, rarely, sometimes and often), severity (never, mild, moderate and severe), and timing (before or after age of menopause, i.e., early or late onset) of VMS and incident CVD were analysed. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). / Results: In the adjusted model, no evidence of association was found between frequency of hot flushes and incident CVD, while women who reported night sweats “sometimes” (HR 1.22, 95% CI 1.02-1.45) or “often” (1.29, 1.05-1.58) had higher risk of CVD. Increased severity of either hot flushes or night sweats was associated with higher risk of CVD. The hazards ratios of CVD in women with severe hot flushes, night sweats and any VMS were 1.83 (1.22, 2.73), 1.59 (1.07, 2.37) and 2.11 (1.62, 2.76) respectively. Women who reported severity for both hot flushes and night sweats had a higher risk of CVD (1.55, 1.24-1.94) than those with hot flushes alone (1.33, 0.94-1.88) and night sweats alone (1.32, 0.84-2.07). Women with either early onset (1.38, 1.10-1.75) or late onset (1.69, 1.32-2.16) VMS had an increased risk of incident CVD, compared with women who did not experience VMS. / Conclusion: Severity rather than frequency of VMS (hot flushes and night sweats) was associated with increased risk of CVD. VMS with onset before or after menopause were also associated with increased risk of CVD.
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