Hot Flashes and Neurovascular Function in Women

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PROJECT SUMMARY/ABSTRACT Vasomotor symptoms (hot flashes) associated with menopause consist of rapid and intense sweating, peripheral vasodilation, and an exaggerated feeling of internal heat. Over 70% of women experience hot flashes at some point during menopause, which significantly impacts day to day life. Furthermore, hot flash frequency is related to increased risk of hypertension, cardiovascular disease (CVD), sleep, and mood disorders--even when controlling for traditional cardiovascular disease risk factors (obesity, hypertension, lipids, etc.). As such, the overall goal of this application is to determine autonomic neurovascular function in midlife women with and without vasomotor symptoms (hot flashes). For the purposes of this application we will define neurovascular function as a concept that encompasses sympathetic outflow, the responses of blood vessels to neurotransmitters released by the sympathetic nerves and the intrinsic properties of the vascular endothelium and smooth muscle. It is thus related to the regulation of tissue blood flow. In this context, neurovascular function is critically important to women’s health and aging. Aim 1 will compare microvascular function in women with objectively assessed low and high frequency hot flashes. Aim 2 will determine autonomic function and reactivity in women with objectively assessed low and high frequency hot flashes. Finally, Aim 3 will characterize cerebrovascular function in women with objectively assessed low and high frequency hot flashes. Importantly, this work will provide the first comprehensive and mechanistic evaluation of autonomic and neurovascular function in midlife women including those undergoing menopause. Understanding how the neurovascular physiology of women relates to hot flashes will inform hypertension and cardiovascular disease (CVD) treatment and prevention options, as the presence of hot flashes are a CVD risk factor beyond traditional CVD risk factors and as such, is likely to be an important determinant for a woman’s health. Thus, the Applicant’s long-term goal is to develop interventions to reduce the incidence of cardiovascular disease in women with hot flashes. The proposed studies will build on the Applicant’s previous training and the mentorship team, formal course work on running clinical trials, and technical training plan will provide opportunities to gain additional knowledge in a new area and learn new experimental techniques and approaches. Finally, this work will generate an investigative niche that will complement the Applicant’s intellectual and technical skills that will facilitate the launch of her independent career.