Hot flushes and night sweats are associated with coronary heart disease risk in midlife: a longitudinal study

Abstract

The purpose of this study was to investigate associations between vasomotor menopausal symptoms (VMS), i.e. hot flushes and night sweats, and the incidence of coronary heart disease (CHD). A prospective cohort study. 11 725 women, aged 45-50 years at baseline in 1996, were followed up at 3-year intervals for 14 years. Self-reported VMS and incident CHD were measured at each survey. We determined the association between VMS and CHD at the subsequent survey, using generalised estimating equation analysis, adjusting for time-varying covariates. At baseline, 14% reported rarely, 17% reported sometimes, and 7% reported often having night sweats. During follow-up, 187 CHD events occurred. In the age-adjusted analysis, women who reported their frequency of experiencing hot flushes and night sweats as 'often' had a greater than two-fold increased odds of CHD (OR hot flushes 2.18, 95% CI 1.49-3.18; OR night sweats 2.38, 95% CI 1.62-3.50) compared with women with no symptoms (P trend<0.001 for frequency of symptoms). Adjustment for menopausal status, lifestyle factors, body mass index, diabetes, and hypertension attenuated the associations (OR hot flushes 1.70, 95% CI 1.16-2.51, P trend=0.01; OR night sweats 1.84, 95% CI 1.24-2.73), P trend=0.004). Women who report having hot flushes or night sweats 'often' have an increased risk of developing CHD over a period of 14years, even after taking the effects of age, menopause status, lifestyle, and other chronic disease risk factors into account.