Menopausal Night Sweats Linked to Coronary Heart Disease

Jim Kling

February 22, 2011

February 22, 2011 — Women who experience night sweats as part of menopause have a moderately increased risk for coronary heart disease (CHD). However, no such relationship is found for women who experience flushing, and the increased risk cannot be explained by cardiovascular disease (CVD) risk factors. The results appear in a study published in the February issue of Menopause.

There is evidence that women with vasomotor menopausal symptoms (VMS) may be at increased risk for CVD. In previous research, the study authors showed that women with VMS also have increased total cholesterol levels, systolic and diastolic blood pressures, body mass index (BMI), glucose level, waist-to-hip ratio, low-density lipoprotein level, and triglyceride level relative to women who do not experience these symptoms.

Another previous study reported that night sweats were associated with reduced mortality risk from CHD, although the relationship disappeared when the authors corrected for CVD risk factors.

To determine if VMS symptoms could be linked to an increased risk for CHD, the researchers, led by Gerrie-Cor M. Gast, PhD, from University Medical Center Utrecht, Utrecht, the Netherlands, used data from 2 Dutch and Swedish population-based samples totaling 10,787 women. Participants were aged 46 to 64 years and were enrolled between 1995 and 2000. They were all free of CVD at baseline.

Questionnaires were used to determine VMS. All of the women had BMI and blood pressure recorded, and a subgroup had total cholesterol levels measured. The researchers used multivariable Cox regression models to analyze the data.

Mean follow-up period was 10.3 years (SD ± 2.1 years), during which 303 women were diagnosed with CHD. The researchers found no association between symptoms of flushing and CHD, but participants with night sweats had a multivariable adjusted hazard ratio (HR) of 1.33 (95% confidence interval [CI], 1.05 - 1.69). Correction for BMI, blood pressure, and total cholesterol level reduced the strength of the association but did not eliminate it (HR, 1.25; 95% CI, 0.99 - 1.58).

In a multivariable adjusted model, the researchers also found similar links between night sweats and CHD in the subset of women who had never used oral contraceptives or hormone therapy, which persisted after adjustment for BMI, blood pressure, and total cholesterol level (HR, 1.35; 95% CI, 1.01 - 1.80).

The study authors suggest that the sympathetic nervous system could be behind a link between night sweats and CHD. Its activity is believed to be higher in symptomatic women, and previous studies have suggested that increased activity may be linked to various vascular abnormalities. Another possibility is that estrogen decline may accompany VMS, and CHD may be a consequence of low estrogen levels.

In an accompanying editorial, Rebecca Hardy, PhD, from University College London in London, United Kingdom, praises the work. "Reproductive health is being increasingly recognized as a sentinel for chronic disease, and the possibility of identifying women at risk of chronic disease through their reproductive health also offers the opportunity of early and targeted intervention," she writes.

This study was supported by an incentive grant from the board of the University Medical Center Utrecht, the Netherlands, and funding from the Region Skåne and the medical faculty of Lund University, Sweden. The study authors and editorialist have disclosed no relevant financial relationships.

Menopause. 2011;18:127-128, 146-151. Abstract

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