Increased risk for cardiovascular disease seen with two or more menopausal symptoms

Reuters Health - 29/09/2020 - Having two or more moderate or severe menopausal symptoms is associated with increased risk for cardiovascular disease (CVD) and stroke, new research indicates.

Women with more (and more bothersome) menopausal symptoms "may be more likely to seek a physician for treatment and this may be an ideal time to assess cardiovascular disease risk," lead author Dr. Matthew Nudy, with Penn State Hershey Medical Center, told Reuters Health by email.

He presented the findings September 28 during the virtual annual meeting of The North American Menopause Society (NAMS).

Other studies have shown that vasomotor symptoms (VMS, hot flashes/night sweats) are associated with CVD, Dr. Nudy explained. The current analysis is "unique," he said, in that a range of menopausal symptoms, other than the core VMS, and their severity were analyzed.

The menopausal symptoms were dizziness, heart racing or skipping beats, tremors, feeling restless or fidgety, feeling tired, difficulty concentrating, forgetfulness, mood swings, vaginal dryness, breast tenderness, headache or migraine, and waking up multiple times at night, in addition to VMS.

This was a secondary analysis including more than 20,000 women from the Women's Health Initiative (WHI)-Calcium and Vitamin D (CaD) trial who were followed for a median of up seven years.

The severity of VMS was not associated with CVD or stroke. However, there was a significant correlation between the number of menopausal symptoms and CVD/stroke risk.

With two or more menopausal symptoms compared with none, the hazard ratio for stroke was 1.41 (95% confidence interval, 1.04 to 1.91). With one menopausal symptom, the hazard ratio for stroke was 1.19 (95% CI, 0.88 to 1.61), Dr. Nudy and colleagues report in their conference abstract.

For total CVD, the hazard ratios were 1.37 (95% CI, 1.20 to 1.56) with two or more menopausal symptoms and 1.00 (95% CI, 0.87 to 1.15) with a single menopausal symptom (vs none; p-trend < 0.001), they note.

Dr. Nudy told Reuters Health, "A sensitivity analysis was performed based on hormone therapy status (never users vs. those women with past or current use at the start of the study). The increased risk of stroke and total CVD among women with more moderate or severe menopausal symptoms was still observed when controlling for hormone therapy."

In an exploratory analysis, the researchers also found that greater severity of the individual menopausal symptoms of restless/fidgety, difficulty concentrating, dizziness, heart racing or skipping beats, feeling tired and forgetfulness were significantly associated with CVD. The severity of night sweats trended towards significance with CVD.

Calcium and vitamin D supplementation did not influence any association.

Commenting on the new results in a conference statement, NAMS medical director Dr. Stephanie Faubion, said, "With heart disease remaining the number one killer of women, studies like this are invaluable. Healthcare providers need to be aware that menopause symptoms may be more than a benign nuisance, and women suffering from these symptoms may be at increased risk for cardiovascular disease. Identifying women at high risk is important so that risk reduction strategies can be implemented."

By Megan Brooks

SOURCE: https://bit.ly/30gxY9w The North American Menopause Society Virtual Annual Meeting, presented September 28, 2020.



Posted on 29 September 202021 October 2020