Menopausal Hot Flashes and Carotid Intima Media Thickness Among Midlife Women.
Menopausal Hot Flashes and Carotid Intima Media Thickness Among Midlife Women.
复制标题
DOI：
10.1161/strokeaha.116.014674
复制
发表时间：
2016-12
期刊：
影响因子：
8.3
通讯作者：
Matthews KA
中科院分区：
文献类型：
--
作者：
Thurston RC;Chang Y;Barinas-Mitchell E;Jennings JR;Landsittel DP;Santoro N;von Känel R;Matthews KA
长期以来，人们一直对绝经期的作用及其与女性心血管疾病（CVD）发展的相关性感兴趣。大多数中年女性都经历过月经潮热;新出现的数据将潮热与CVD风险指标联系起来。我们测试了通过最先进的生理学方法测量的潮热是否与颈动脉超声评估的更严重的亚临床动脉粥样硬化相关。我们考虑了CVD危险因素和雌二醇浓度在这些关联中的作用。295名无临床CVD的非吸烟女性进行了动态生理性潮热评估;抽血;颈动脉超声测量IMT和斑块。在控制CVD危险因素和雌二醇的回归模型中，测试了潮热和亚临床动脉粥样硬化之间的关系。更频繁的生理性潮热与更高的颈动脉内膜中层厚度[IMT;对于每次额外的潮热：β（标准误差）=.004（.001），p=.0001;报告的潮热：β（标准误差）=.008（.002），p=.002，多变量]和斑块[例如，每日报告潮热的女性中，每增加一次潮热，斑块指数≥2的比值比（95%置信区间）=1.07（1.003-1.14，p= 0.04），相对于无斑块，多变量]; CVD风险因素或雌二醇未解释相关性。在报告潮热的女性中，潮热比大多数CVD危险因素更能解释IMT的变化。在报告每日潮热的女性中，频繁的潮热可能提供关于女性血管状态的信息，而不是标准的CVD风险因素和雌二醇。频繁的潮热可能标志着中年女性血管表型的脆弱性。
There has been a longstanding interest in the role of menopause and its correlates in the development of cardiovascular disease (CVD) in women. Menopausal hot flashes are experienced by most midlife women; emerging data link hot flashes to CVD risk indicators. We tested whether hot flashes, measured via state-of-the-art physiologic methods, were associated with greater subclinical atherosclerosis as assessed by carotid ultrasound. We considered the role of CVD risk factors and estradiol concentrations in these associations. 295 nonsmoking women free of clinical CVD underwent ambulatory physiologic hot flash assessments; a blood draw; and carotid ultrasound measurement of IMT and plaque. Associations between hot flashes and subclinical atherosclerosis were tested in regression models controlling for CVD risk factors and estradiol. More frequent physiologic hot flashes were associated with higher carotid intima media thickness [IMT; for each additional hot flash: beta (standard error)=.004(.001), p=.0001; reported hot flash: beta (standard error)=.008(.002), p=.002, multivariable] and plaque [e.g., for each additional hot flash, odds ratio (95% confidence interval) plaque index ≥2=1.07(1.003–1.14, p=.04), relative to no plaque, multivariable] among women reporting daily hot flashes; associations were not accounted for by CVD risk factors or by estradiol. Among women reporting hot flashes, hot flashes accounted for more variance in IMT than most CVD risk factors. Among women reporting daily hot flashes, frequent hot flashes may provide information about a woman’s vascular status beyond standard CVD risk factors and estradiol. Frequent hot flashes may mark a vulnerable vascular phenotype among midlife women.