Vasomotor symptoms and cardiovascular health: findings from the SWAN and the MsHeart/MsBrain studies

Abstract

Vasomotor symptoms (VMS) are often considered the classic menopausal symptom and are experienced by most women during the menopause transition. VMS are well established to be associated with decrements in quality of life during the menopause. More recent research also links VMS to poorer cardiovascular health. This review summarizes key insights about links between VMS and cardiovascular disease (CVD) risk that come from the Study of Women’s Health Across the Nation (SWAN), a longitudinal epidemiologic cohort study of the menopause transition, as well as from the MsHeart/MsBrain studies, clinical studies that leverage vascular imaging and brain imaging as well as wearable technologies that provide objective indicators of VMS. Using a range of methodologies and extensive consideration of confounders, these studies have shown that frequent and/or persistent VMS are associated with adverse CVD risk factor profiles, poorer underlying peripheral vascular and cerebrovascular health, and elevated risk for clinical CVD events. Collectively, the SWAN and MsHeart/MsBrain studies form complementary epidemiologic and clinical studies that point to the importance of VMS to women’s cardiovascular health during the menopause transition and beyond.

摘要

血管舒缩症状（VMS）通常被认为是典型的绝经症状, 大多数妇女在绝经过渡期都会经历。VMS与绝经期生活质量的下降有关。最近的研究也将VMS与心血管健康状况较差联系起来。这篇综述总结了来自“跨国妇女健康研究”（SWAN）的见解, 该研究是一个关于绝经期的纵向流行病学队列研究, 以及来自MsHeart/MsBrain研究的见解, 这是一项利用血管成像、脑部成像以及提供潮热症状客观指标的可穿戴技术的临床研究。通过采用多种方法和广泛考虑混杂因素, 这些研究表明, 频繁和/或持续的VMS与不利的心血管疾病（CVD）风险因素、较差的外周血管和脑血管健康以及临床CVD事件升高的风险相关联。总体而言, SWAN和MsHeart/MsBrain研究形成了互补的流行病学和临床研究, 强调了在绝经过渡期及以后VMS对女性心血管健康的重要性。

Keywords:

• Vasomotor symptoms
• hot flashes
• hot flushes
• cardiovascular disease
• cerebrovascular disease
• heart attack
• stroke
• atherosclerosis
• endothelial function

Acknowledgements

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR), the National Institutes of Health (NIH) Office of Research on Women’s Health (ORWH) or the NIH.

Potential conflict of interest

R. C. Thurston is a consultant/advisor for Astellas, Bayer, Happify Health and Hello Therapeutics.

Source of funding

The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) [Grant U01NR004061], [Grant U01AG012505], [Grant U01AG012535], [Grant U01AG012531], [Grant U01AG012539], [Grant U01AG012546], [Grant U01AG012553], [Grant U01AG012554], [Grant U01AG012495], and [Grant U19AG063720]. This research was also supported by the NIH, NIA [RF1AG053504 and R01AG53504]; NIH Heart Lung and Blood Institute [R01HL105647], [K24HL123565 ]. This work was also supported by the University of Pittsburgh Clinical and Translational Science Institute [NIH Grant UL1TR000005]; University of Pittsburgh Small Molecule Biomarker Core [NIH Grant S10RR023461].

Additional information

Funding

The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) [Grant U01NR004061], [Grant U01AG012505], [Grant U01AG012535], [Grant U01AG012531], [Grant U01AG012539], [Grant U01AG012546], [Grant U01AG012553], [Grant U01AG012554], [Grant U01AG012495], and [Grant U19AG063720]. This research was also supported by the NIH, NIA [RF1AG053504 to R. C. Thurston and Maki]; NIH Heart Lung and Blood Institute [R01HL105647 to R. C. Thurston], [2K24HL123565 to R. C. Thurston]. This work was also supported by the University of Pittsburgh Clinical and Translational Science Institute [NIH Grant UL1TR000005]; University of Pittsburgh Small Molecule Biomarker Core [NIH Grant S10RR023461].