Menopause-Hormone-Treatment-Heart-Disease-RiskWomen who have hot flashes earlier in life may have less healthy blood vessels than those who develop the menopausal symptom later in life or not at all, according to two new studies.

Women and their doctors tend to think of hot flashes solely as a quality of life concern. Yet the new findings suggest early-onset hot flashes may also be a red flag that can help identify women at increased cardiovascular risk, said Rebecca Thurston, Ph.D., who led both studies.

The government-funded studies, to be presented March 16 at the American College of Cardiology’s Scientific Session, add to research linking hot flashes with cardiovascular risk. That risk manifests through what is medically known as endothelial dysfunction, meaning the blood vessels are not able to expand normally during exercise and other period of physical stress. Endothelial dysfunction is the earliest sign of cardiovascular disease.

In one study, healthy women wore a hot flash monitor for 24 hours. Women age 52 and younger were more likely than older women to have hot flashes associated with poorer expansion of the blood vessels. And the more hot flashes a younger woman had, the more evidence of endothelial dysfunction.

The second study came to a similar conclusion: Among women who already had signs of heart disease, those who reported having hot flashes at age 42 or younger had poorer expansion of the blood vessels than women whose symptoms started later.

More than 70 percent of women experience hot flashes and night sweats at some point during menopause, according to earlier research. While the drop in hormone levels that accompanies menopause is thought to trigger hot flashes, experts say little is known about what happens when a woman has one.

Thurston said the new research may help identify who could benefit from more aggressive cardiovascular prevention strategies early in midlife. However, it is unknown whether directly treating hot flashes could prevent heart-related effects, she noted.

“Right now, our traditional [cardiovascular] risk algorithms don’t tend to predict among women as well as among men, particularly among women at midlife,” said Thurston, an associate professor of psychiatry, psychology and epidemiology at the University of Pittsburgh.

At the very least, she said, it could pinpoint which women may need a more rigorous risk assessment because doctors “might not typically do that for women in their 40s.”

Thurston said more research is needed to refine the exact age at which hot flashes seem to be most associated with worse endothelial dysfunction and to investigate whether the severity of hot flashes plays a role. Research is also needed to investigate the association of hot flashes with cardiovascular events, she said.