Mechanisms linking hot flashes to cardiovascular risk

潮热与心血管风险的关联机制

基本信息

批准号：
8701365
负责人：
REBECCA C THURSTON
金额：
$ 66.88万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-01 至 2016-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8701365
关键词：
Accounting Acute Address Affect Age Algorithms Ambulatory Electrocardiography Atherosclerosis Attention Behavioral Benign Blood Pressure Blood specimen Body mass index Cardiac Cardiovascular Diseases Cardiovascular system Carotid Arteries Cause of Death Cessation of life Coagulation Process Development Diabetes Mellitus Estradiol Estrogens Event Frequencies Functional disorder Health Heart Heart Diseases Hemostatic Agents Hormones Hot flushes Hour Hypertension Inflammation Inflammatory Investigation Linear Regressions Link Lipids Measurement Measures Mediating Menopausal Symptom Menopause Modeling Monitor Obesity Observational Study Participant Pathway interactions Patient Self-Report Perimenopause Pharmaceutical Preparations Physiological Physiology Postmenopause Process Progestins Quality of life Relative (related person)Reliance Reporting Research Research Design Research Personnel Risk Risk Factors Sampling Smoking Symptoms Testing Text Thick Ultrasonography Vasomotor Woman Women&apos s Health Work aged brachial artery calcification cardiovascular disorder risk cardiovascular risk factor design diaries endothelial dysfunction experience heart rate variability improved indexing intima media men middle age mortality non-smoker novel novel marker older women reproductive reproductive hormone

项目摘要

DESCRIPTION (provided by applicant): Two major health issues facing women as they age are cardiovascular disease (CVD) and menopausal hot flashes. CVD is the leading cause of death among women. Hot flashes are experienced by many midlife women, and for 30% of women, they are frequent or severe. Although hot flashes are traditionally regarded as a benign midlife symptom, recent research has linked a high burden of hot flashes to CVD risk. Several large trials have indicated that the greatest risk of cardiovascular events with hormone use appears concentrated among women reporting moderate to severe hot flashes. Our research shows elevated subclinical CVD among women reporting frequent hot flashes. Important mechanisms linking a high burden of hot flashes to CVD risk may be changes in endothelial function, inflammation/coagulation and cardiac vagal control. However, findings linking hot flashes to cardiovascular risk are just emerging. None of these studies was designed to examine associations between hot flashes and cardiovascular risk. Most have notable limitations, including the reliance upon crude, self-report measures of hot flashes vulnerable to multiple biases. The aim of this investigation is to examine whether women with daily hot flashes have adverse indicators of cardiovascular risk, including poorer endothelial function, higher carotid intima media thickness, lower cardiac vagal control, and an adverse inflammatory and hemostatic profile, relative to women without hot flashes. It is hypothesized that these differences will be independent of traditional CVD risk factors. Secondary aims include testing acute changes in cardiac vagal control during hot flashes and examining key pathways involved in these associations. The proposed sample includes 300 perimenopausal and postmenopausal women aged 40-60, half with daily hot flashes and half without hot flashes. Participants will be nonsmokers, free of heart disease and treated diabetes or hypertension, and free of medications impacting hot flashes. All women will undergo 3 days of physiologic hot flash monitoring, 24 hours of which will include ambulatory electrocardiography for measurement of cardiac vagal control (high frequency heart rate variability), a brachial artery ultrasound for measurement of endothelial function (flow mediated dilation), a carotid artery ultrasound for measurement of intima media thickness, and a blood sample for assessment of inflammatory/hemostatic markers and estradiol concentrations. Relations between hot flashes and cardiovascular risk indicators will be examined using linear regression and linear mixed models. This study represents the first study specifically designed to examine relations between hot flashes and CVD risk, and is an important first step in better understanding links between hot flashes and CVD risk. Addressing these aims may inform a better understanding of the physiology of hot flashes and support the development of a novel marker of cardiovascular risk among midlife women. This work has the potential to challenge the way that this presumably benign menopausal symptom is understood by researchers, clinicians, and women.

描述（由申请人提供）：随着年龄的增长，妇女面临的两个主要健康问题是心血管疾病（CVD）和更年期的潮热。 CVD是妇女死亡的主要原因。许多中年女性经历了潮热，对于30％的女性，她们经常或严重。尽管传统上将潮热被视为中年症状，但最近的研究将高闪光的负担与CVD风险联系起来。几项大型试验表明，使用激素使用的心血管事件的最大风险似乎集中在报告中度至重度潮热的女性中。我们的研究表明，在报告频繁潮热的女性中，亚临床CVD升高。将高潮负担与CVD风险联系起来的重要机制可能是内皮功能，炎症/凝结和心脏迷走神经控制的变化。但是，将潮热与心血管风险联系起来的发现只是出现。这些研究均未旨在检查潮热与心血管风险之间的关联。大多数人都有明显的局限性，包括依赖原油，自我报告的潮热测量，这些速度容易受到多种偏见的影响。这项调查的目的是检查每天有潮热的女性是否具有心血管风险的不利指标，包括较差的内皮功能，较高的颈动脉内膜培养基厚度，较低的心脏迷走神经控制以及不良炎症和止血性，相对于没有热闪光的女性。假设这些差异将独立于传统的CVD风险因素。次要目的包括在热闪光期间测试心脏迷走神经控制的急性变化，并检查这些关联中涉及的关键途径。拟议的样本包括300个围绝经期和绝经后妇女，年龄40-60岁，每天有一半，每天有热闪光，一半没有热闪光。参与者将是非吸烟者，没有心脏病和治疗的糖尿病或高血压，并且没有影响潮热的药物。所有妇女将接受3天的生理热闪光监测，其中24小时将包括心理心电图检查，用于测量心脏迷走神经控制（高频心率可变性），一种用于测量内皮功能（流动介导的膨胀）的臂动脉超声，用于测量颈动脉超强/较高的杂物，并评估了较高的培养基，并进行了较高的材料，并进行了较高的材料厚度，并进行了较高的材料厚度，并进行了较高的样子厚度，并进行了较高的样子，并进行了较高的材料厚度，并且雌二醇浓度。潮热与心血管风险指标之间的关系将使用线性回归和线性混合模型检查。这项研究代表了专门旨在检查潮热与CVD风险之间关系的第一项研究，并且是更好地理解潮热与CVD风险之间联系的重要第一步。解决这些目标可能会更好地了解潮热的生理，并支持中年女性心血管风险的新颖标志的发展。这项工作有可能挑战研究人员，临床医生和妇女对这种良性更年期症状的理解方式。