Classic Symptoms of Hot Flashes or Night Sweats Occurring at the Time of Menopause Do Not Appear to be a Harbinger of Increased Cardiovascular Risk

New research suggests that women who suffer from hot flashes and night sweats may be at lower risk for cardiovascular disease, stroke and death.  The research titled “Vasomotor symptoms and cardiovascular events in postmenopausal women,” is published in the online edition of the journal Menopause.

“Hot flashes and night sweats may mean different things about a woman’s risk for heart disease depending on their timing with menopause,” said Ellen Seely, MD, senior author of the paper and a physician in the Division of Endocrinology at Brigham and Women’s Hospital.  “When they occur early in menopause, they do not appear to be associated with increased risk for heart disease. However, this study suggests that women who have new onset of these symptoms many years after the start of menopause may have increased risk for heart disease.  This latter group of women deserves further study to determine if an intervention in this population could lower their risk for heart disease.”

The research suggests that symptoms of hot flashes or night sweats in newly menopausal women are NOT linked to an increased risk of heart attack or stroke but are a marker of increased risk if the symptoms start in later menopause. Researchers at Northwestern and Brigham and Women’s Hospital studied more than 60,000 women in the Women’s Health Initiative over an average of 10 years and found:

  • Women with hot flashes or night sweats at the onset of menopause had NO increase in heart attack, stroke, or all-cause mortality compared to women without these symptoms. In fact, they had a trend toward slightly lower risk than women without hot flashes (17% lower risk of stroke, 11% lower risk of total cardiovascular disease, and 8% lower risk of death).
  • Women who did not have hot flashes or night sweats at the onset of menopause but developed them later in menopause (with symptoms present at the time of study enrollment when the women were an average of 63 years) had significantly HIGHER risks of cardiovascular disease and all-cause mortality (32% higher risk of heart attack and 29% higher risk of death).
  • Women who had hot flashes or night sweats at the onset of menopause and whose symptoms persisted into later menopause had neutral risk (no increase or decrease.)

“Our study provides reassurance that the classic symptoms of early menopause, experienced by the majority of women at mid-life, are not a marker of an increased risk of heart attack or stroke in the future,” said JoAnn Manson, MD, coauthor and Chief of Preventive Medicine at Brigham and Women’s Hospital.

Researchers conclude that the role of hot flashes or night sweats in predicting risk of CVD in women may vary according to the timing of the onset of symptoms and whether symptoms are present at different stages of menopause. Symptoms occurring early, at the start of menopause, were associated with decreased risk of stroke, total CVD events, and all-cause mortality.  Symptoms starting in later menopause were associated with increased heart disease risk and all-cause mortality.

Researchers note that further research is needed to better understand the mechanisms underlying these associations.