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Researchers say persistent hot flashes during menopause may indicate a higher risk of cardiovascular disease. Getty Images
  • Researchers say persistent hot flashes could be a sign of a higher risk of cardiovascular disease.
  • They say the study is important because it focused on women in their 40s and 50s and followed them for 20 years.
  • The research may help medical professionals and older women work on strategies to prevent heart disease.

For years, the conventional wisdom was that hot flashes were a rather benign signal that a woman was about to enter midlife.

Now, a new study out of the University of Pittsburgh says not so fast.

Frequent or persistent hot flashes could be a sign that you’re at higher risk for a heart attack or stroke.

The study on hot flashes, or what doctors call vasomotor symptoms, and their link to cardiovascular disease is set to be presented this week in Chicago at the annual meeting of The North American Menopause Society.

“We found that frequent as well as persistent vasomotor symptoms over the menopausal transition period translated into a higher risk of having a cardiovascular disease event over the next 20 years,” Rebecca Thurston, PhD, the study’s lead author and a professor of psychiatry, clinical and translational science, epidemiology, and psychology at the University of Pittsburgh, told Healthline.

Thurston said that after controlling for things such as age, race, and ethnicity, the magnitude of the effects was about a 50 to 80 percent increased risk.

The study is based on data from SWAN, the Study of Women’s Health Across the Nation, that focused on the menopause transition.

SWAN enrolled 3,300 women in the early ’90s. They were ages 42 to 52 who were pre or early perimenopausal. They included white, African American, Asian American and Hispanic women.

Researchers followed the women for more than 20 years. They were able to track and analyze hot flashes and how they were linked to cardiovascular disease down the road.

“Prior studies were typically talking to women who were a little bit older, maybe in their 60s. They were trying to recall what their hot flashes were like, but it’s hard to do that with a lot of accuracy and precision,” Thurston said.

“It’s much better to ask women as they are having those symptoms. That was the strength of this study. We had women coming into our labs 16 visits over the course of the 22-year follow-up period,” she explained.

“We do a less good job of predicting what women at midlife will go on to have cardiovascular disease in their 60s, 70s, 80s than we do for men. So, having these female-specific markers of disease is important,” Thurston explained.

“Two key things that really set this study apart from others is that it’s large and it was quite a diverse population with great ethnic representation,” Dr. Kathryn Rexrode, the chief of the division of women’s health at Brigham and Women’s Hospital in Massachusetts and an associate professor of medicine at Harvard Medical School, told Healthline.

“We’re trying to understand the risk factors for cardiovascular disease that are specific to women. In recent years, pregnancy exposures have gotten attention as well as the timing of menopause,” Rexrode said. “This study provides very important information on menopausal symptoms and long-term cardiovascular events.”

Dr. Tracy Stevens agrees.

She is a cardiologist with Saint Luke’s Mid America Heart Institute in Kansas City and a professor of medicine at the University of Missouri-Kansas City School of Medicine.

“Unfortunately, before now, there’s not been a lot of studies of large numbers of women to really confirm what we know or what we don’t know,” Stevens told Healthline.

“Predominantly what we did in the past was study 50-year-old white men. I tell my patients that our best advocates were rats who had had their ovaries out because you could study large numbers of them,” she added.

Dr. Gina Price Lundberg is a preventive cardiologist, clinical director of the Emory Women’s Heart Center, and an associate professor of medicine at Emory University School of Medicine in Georgia.

She says the takeaway for both doctors and older women is to focus on prevention.

“This is a woman who needs to be watched more closely, needs a heart-healthy diet, routine exercise, ideal body weight, and aggressive cardiovascular disease risk reduction therapy,” she told Healthline. “She needs to have her cholesterol, blood pressure, and blood sugar checked routinely regardless of how ‘fit or healthy’ she looks.”

Stevens encourages women to “take ownership of your health, be on top of strategies that protect you from heart attack and stroke. If you’re experiencing hot flashes, talk to your doctor.”

Thurston says more research is needed to find the cause of the link between the frequent, persistent hot flashes and increased risk for heart attack and stroke.

“We don’t know whether treating the hot flashes will improve women’s cardiovascular health. We haven’t done that research yet. We hope to,” she said. “This does not provide any recommendations whether women should be using hormone therapy. We need to do that research.”