Hot flashes and subclinical cardiovascular disease: findings from the Study of Women's Health Across the Nation Heart Study.
Hot flashes and subclinical cardiovascular disease: findings from the Study of Women's Health Across the Nation Heart Study.
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DOI：
10.1161/circulationaha.108.776823
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发表时间：
2008-09-16
期刊：
影响因子：
37.8
通讯作者：
Matthews KA
中科院分区：
文献类型：
--
作者：
Thurston RC;Sutton-Tyrrell K;Everson-Rose SA;Hess R;Matthews KA
尽管有证据表明，女性潮热患者存在不良血管变化，但尚不清楚潮热是否与亚临床心血管疾病（CVD）相关。本研究旨在探讨绝经期潮热与亚临床心血管疾病指标的关系。我们假设与没有潮热的女性相比，有潮热的女性会表现出血流介导的扩张减少，冠状动脉和主动脉钙化更大。SWAN心脏研究（2001-2003）是全国妇女健康研究的辅助研究，这是一项基于社区的队列研究。参与者为492名女性（35%非裔美国人，65%白种人），年龄45-58岁，无临床心血管疾病，有子宫和≥一个卵巢。测量方法包括肱动脉超声检查以评估血流介导的扩张，电子束断层扫描以评估冠状动脉和主动脉钙化，报告的潮热（有/无，前两周），以及测量雌二醇浓度的血液样本。采用线性回归和部分比例优势模型评估横截面相关性。在年龄和种族调整的模型中，潮热与血流介导的扩张显著降低(β (SE)= - 1.01(0.41), p=0.01)、冠状动脉扩张(优势比（OR)=1.48, 95%可信区间（CI） 1.04-2.12）和主动脉钙化（OR=1.55, 95%CI 1.10-2.19）相关。在心血管疾病危险因素和雌二醇校正的模型中，潮热与血流介导的舒张(β (SE)= - 0.97(0.44), p=0.03)和主动脉钙化（OR=1.63, 95%CI 1.07-2.49）仍然存在显著关联。潮热女性血流介导的扩张减少，主动脉钙化更严重。在中年妇女中，潮热可能标志着不利的潜在血管变化。
Although evidence suggests adverse vascular changes among women with hot flashes, it is unknown whether hot flashes are associated with subclinical cardiovascular disease (CVD). The study aim was to examine relations between menopausal hot flashes and indices of subclinical CVD. We hypothesized that women with hot flashes would show reduced flow mediated dilation and greater coronary artery and aortic calcification versus women without hot flashes. The SWAN Heart Study (2001–2003) is an ancillary study to the Study of Women’s Health Across the Nation, a community-based cohort study. Participants were 492 women (35% African American, 65% Caucasian) ages 45–58, free of clinical CVD, and with a uterus and ≥one ovary. Measures included a brachial artery ultrasound to assess flow mediated dilation, electron beam tomography to assess coronary artery and aortic calcification, reported hot flashes (any/none, previous two weeks), and a blood sample for measurement of estradiol concentrations. Cross-sectional associations were evaluated with linear regression and partial proportional odds models. Hot flashes were associated with significantly lower flow mediated dilation (beta(SE)=−1.01(0.41), p=0.01), and greater coronary artery (odds ratio (OR)=1.48, 95% confidence interval (CI) 1.04–2.12) and aortic calcification (OR=1.55, 95%CI 1.10–2.19) in age and race-adjusted models. Significant associations between hot flashes and flow mediated dilation (beta(SE)= −0.97(0.44), p=0.03) and aortic calcification (OR=1.63, 95%CI 1.07–2.49) remained in models adjusted for CVD risk factors and estradiol. Women with hot flashes had reduced flow mediated dilation and greater aortic calcification. Hot flashes may mark adverse underlying vascular changes among midlife women.