Skip to main content
SpringerLink
Log in

Vasomotor Symptoms, Metabolic Syndrome, and Cardiovascular Risks

  • Chapter
  • First Online:
Postmenopausal Diseases and Disorders

  • 624 Accesses

Abstract

Vasomotor symptoms (VMS), such as hot flushes and night sweats, are common during the menopausal transition. Although the underlying etiopathology behind vasomotor symptoms is not fully identified, they have been associated with an overdrive of the sympathetic nervous system, which in turn may result in altered vascular function, changes in blood pressure (BP) and lipids, and the development of insulin resistance. Metabolic syndrome (MetS) is a cluster of closely related risk factors for cardiovascular disease (CVD): elevated BP, dyslipidemia, hyperglycemia, and central obesity. Thus, VMS and MetS share a common nominator, sympathetic overactivity. As of lately, due to these associations, the presence of VMS has gained interest as a possible risk factor for CVD. However, the results are mixed, and interpretation of findings is further complicated by the fact that some researchers distinguish between hot flushes and night sweats and others do not. In this chapter we present the most recent data on the possible relations between menopausal vasomotor symptoms, the components of metabolic syndrome, and cardiovascular disease.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Freedman RR. Menopausal hot flashes: mechanisms, endocrinology, treatment. J Steroid Biochem Mol Biol. 2014;142:115–20.

    Article  CAS  Google Scholar 

  2. Schlaich M, Straznicky N, Lambert E, Lambert G. Metabolic syndrome: a sympathetic disease? Lancet Diabetes Endocrinol. 2015;3:148–57.

    Article  Google Scholar 

  3. Vongpatanasin W. Autonomic regulation of blood pressure in menopause. Semin Reprod Med. 2009;27:338–45.

    Article  Google Scholar 

  4. Lambert E, Straznicky N, Sari CI, et al. Dyslipidemia is associated with sympathetic nervous activation and impaired endothelial function in young females. Am J Hypertens. 2013;26:250–6.

    Article  CAS  Google Scholar 

  5. Hitchcock CL, Elliott TG, Norman EG, Tajic V, Teede H, Prior JC. Hot flushes and night sweats differ in associations with cardiovascular markers in healthy early postmenopausal women. Menopause. 2012;19:1208–14.

    Article  Google Scholar 

  6. Tuomikoski P, Haapalahti P, Ylikorkala O, Mikkola TS. Vasomotor hot flushes and 24-hour ambulatory blood pressure in recently post-menopausal women. Ann Med. 2010;42:216–22.

    Article  Google Scholar 

  7. Silveira JS, Clapauch R, Souza MD, Bouskela E. Hot flashes: emerging cardiovascular risk factors in recent and late postmenopause and their association with higher blood pressure. Menopause. 2016;23:846–55.

    Article  Google Scholar 

  8. Thurston RC, Joffe H. Vasomotor symptoms and menopause: findings from the study of Women’s health across the nation. Obstet Gynecol Clin North Am. 2011;38:489–501.

    Article  Google Scholar 

  9. Jackson EA, El Khoudary SR, Crawford SL, Matthews K, Joffe H, Chae C, et al. Hot flash frequency and blood pressure: data from the study of Women’s health across the nation. J Womens Health (Larchmt). 2016;25:1204–9.

    Article  Google Scholar 

  10. Thurston RC, El Khoudary SR, Sutton-Tyrrell K, Crandall CJ, Gold EB, Sternfeld B, et al. Vasomotor symptoms and lipid profiles in women transitioning through menopause. Obstet Gynecol. 2012;119:753–61.

    Article  CAS  Google Scholar 

  11. Franco OH, Muka T, Colpani V, Kunutsor S, Chowdhury S, Chowdhury R, Kavousi M. Vasomotor symptoms in women and cardiovascular risk markers: systematic review and meta-analysis. Maturitas. 2015;81:353–61.

    Article  Google Scholar 

  12. Ryu KJ, Park HT, Kwon DH, Yang KS, Kim YJ, et al. Vasomotor symptoms and metabolic syndrome in Korean postmenopausal women. Menopause. 2015;22:1239–45.

    Article  Google Scholar 

  13. van Dijk GM, Maneva M, Colpani V, Dhana K, Muka T, Jaspers L, et al. The association between vasomotor symptoms and metabolic health in peri- and postmenopausal women: a systematic review. Maturitas. 2015;80:140–7.

    Article  Google Scholar 

  14. Tuomikoski P, Savolainen-Peltonen H. Vasomotor symptoms and metabolic syndrome. Maturitas. 2017;97:61–5.

    Article  CAS  Google Scholar 

  15. Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol. 2008;28:629–36.

    Article  CAS  Google Scholar 

  16. Sowers M, Zheng H, Tomey K, Karvonen-Gutierrez C, Jannausch M, Li X, et al. Changes in body composition in women over six years at midlife: ovarian and chronological aging. J Clin Endocrinol Metab. 2007;92:895–901.

    Article  CAS  Google Scholar 

  17. Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes. 2008;32:949–58.

    Article  CAS  Google Scholar 

  18. Abdulnour J, Doucet E, Brochu M, Lavoie JM, Strychar I, Rabasa-Lhoret R, et al. The effect of the menopausal transition on body composition and cardiometabolic risk factors: a Montreal-Ottawa new emerging team group study. Menopause. 2012;19:760–7.

    Article  Google Scholar 

  19. Gallicchio L, Visvanathan K, Miller SR, Babus J, Lewis LM, Zacur H, et al. Body mass, estrogen levels, and hot flashes in midlife women. Am J Obstet Gynecol. 2005;193:1353–60.

    Article  CAS  Google Scholar 

  20. Gold EB, Colvin A, Avis N, Bromberger J, Greendale GA, Powell L, et al. Longitudinal analysis of the association between vasomotor symptoms and race/ethnicity across the menopausal transition: study of women’s health across the nation. Am J Public Health. 2006;96:1226–35.

    Article  Google Scholar 

  21. Thurston RC, Sowers MR, Sutton-Tyrrell K, Everson-Rose SA, Lewis TT, Edmundowicz D, et al. Abdominal adiposity and hot flashes among midlife women. Menopause. 2008;15:429–34.

    Article  Google Scholar 

  22. Thurston RC, Chang Y, Mancuso P, Matthews KA. Adipokines, adiposity, and vasomotor symptoms during the menopause transition: findings from the study of Women’s health across the nation. Fertil Steril. 2013;100:793–800.

    Article  CAS  Google Scholar 

  23. Karastergiou K, Mohamed-Ali V. The autocrine and paracrine roles of adipokines. Mol Cell Endocrinol. 2010;318(1–2):69–78.

    Article  CAS  Google Scholar 

  24. Luheshi GN, Gardner JD, Rushforth DA, Loudon AS, Rothwell NJ. Leptin actions on food intake and body temperature are mediated by IL-1. Proc Natl Acad Sci U S A. 1999;96:7047–52.

    Article  CAS  Google Scholar 

  25. Jéquier E. Leptin signaling, adiposity, and energy balance. Ann N Y Acad Sci. 2002;967:379–88.

    Article  Google Scholar 

  26. Thorp AA, Schlaich MP. Relevance of sympathetic nervous system activation in obesity and metabolic syndrome. J Diabetes Res. 2015;2015:341583.

    Article  Google Scholar 

  27. Thurston RC, El Khoudary SR, Sutton-Tyrrell K, Crandall CJ, Sternfeld B, Joffe H, et al. Vasomotor symptoms and insulin resistance in the study of women’s health across the nation. J Clin Endocrinol Metab. 2012;97:3487–94.

    Article  CAS  Google Scholar 

  28. Lee SW, Jo HH, Kim MR, Kwon DJ, You YO, Kim JH. Association between menopausal symptoms and metabolic syndrome in postmenopausal women. Arch Gynecol Obstet. 2012;285:541–8.

    Article  Google Scholar 

  29. Gast GC, Samsioe GN, Grobbee DE, Nilsson PM, van der Schouw YT. Vasomotor symptoms, estradiol levels and cardiovascular risk profile in women. Maturitas. 2010;66:285–90.

    Article  CAS  Google Scholar 

  30. Kwon DH, Lee JH, Ryu KJ, Park HT, Kim T. Vasomotor symptoms and the homeostatic model assessment of insulin-resistance in Korean postmenopausal women. Obstet Gynecol Sci. 2016;59:45–9.

    Article  CAS  Google Scholar 

  31. Thurston RC, Sutton-Tyrell K, Everson-Rose SA, Hess R, Matthews KA. Hot flashes and subclinical cardiovascular disease. Findings from the study of women’s health across the nation heart study. Circulation. 2008;118:1234–40.

    Article  Google Scholar 

  32. Thurston RC, Sutton-Tyrell K, Everson-Rose SA, Hess R, Powell LH, Matthews KA. Hot flashes and carotid intima media thickness among midlife women. Menopause. 2011;18:352–8.

    Article  Google Scholar 

  33. Thurston RC, El Khoudary SR, Tepper PG, et al. Trajectories of vasomotor symptoms and carotid intima media thickness in the study of women’s health across the nation. Stroke. 2016;47:12–7.

    Article  Google Scholar 

  34. Tuomikoski P, Ebert P, Haapalahti P, Hautamäki H, Rönnback M, Ylikorkala O, et al. Evidence for a role of hot flushes in vascular function in recently postmenopausal women. Obstet Gynecol. 2009;113:902–8.

    Article  Google Scholar 

  35. Wolff EF, He Y, Black DM, Brinton EA, Budoff MJ, Cerdars MI, et al. Self-reported menopausal symptoms, coronary artery calcification, and carotid intima-media thickness in recently menopausal women screened for the Kronos early estrogen prevention study (KEEPS). Fertil Steril. 2013;99:1385–91.

    Article  Google Scholar 

  36. Allison MA, Manson JE, Aragaki A, Langer RD, Rossouw J, Curb D, et al. Vasomotor symptoms and coronary artery calcium in postmenopausal women. Menopause. 2010;17:1136–45.

    Article  Google Scholar 

  37. Tuomikoski P, Haapalahti P, Sarna S, Ylikorkala O, Mikkola TS. Vasomotor hot flushes and 24-hour ambulatory blood pressure in normotensive women: a placebo-controlled trial on post-menopausal hormone therapy. Ann Med. 2010;42:334–43.

    Article  CAS  Google Scholar 

  38. Ferri LA, Morici N, Bassanelli G, Fraqnco N, Misuraca L, Lenatti L, et al. History of vasomotor symptoms, extent of coronary artery disease, and clinical outcomes after acute coronary syndrome in postmenopausal women. Menopause. 2018;25:635–40.

    Article  Google Scholar 

  39. Herber-Gast GCM, Brown WJ, Mishra GD. Hot flushes and night sweats are associated with coronary heart disease risk in midlife: a longitudinal study. BJOG. 2015;122:1560–7.

    Article  Google Scholar 

  40. Svartberg J, von Muhlen D, Kritz-Silverstein D, Barrett-Connor E. Vasomotor symptoms and mortality: the Rancho Bernardo study. Menopause. 2009;16:888–91.

    Article  Google Scholar 

  41. Avis NE, Crawford SL, Greendale G, Bromberger JT, Everson-Rose SA, Gold EB, et al. Duration of menopausal vasomotor symptoms over the menopause transition. Study of women’s health across the nation. JAMA Intern Med. 2015;175:531–9.

    Article  Google Scholar 

  42. Mikkola TS, Tuomikoski P, Lyytinen H, Korhonen P, Hoti F, Vattulainen P, et al. Increased cardiovascular mortality risk in women discontinuing postmenopausal hormone therapy. J Clin Endocrinol Metab. 2015;100:4588–94.

    Article  CAS  Google Scholar 

  43. Venetkoski M, Savolainen-Peltonen H, Rahkola-Soisalo P, Hoti F, Vattulainen P, Gissler M, et al. Increased cardiac and stroke death risk in the first year after discontinuation of postmenopausal hormone therapy. Menopause. 2018;25:375–9.

    PubMed  Google Scholar 

  44. Manson JE, Chlebowski RT, Stefanick ML, Aragaki AK, Rossouw JE, Prentice RL, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA. 2013;310:1353–68.

    Article  CAS  Google Scholar 

  45. Grady D, Herrington D, Bittner V, Blumenthal R, Davidson M, Hlatky M, et al.; HERS Research Group. Cardiovascular disease outcomes during 6.8 years of hormone therapy: heart and estrogen/progestin replacement study follow-up (HERS II). JAMA. 2002;288:49–57.

    Article  Google Scholar 

  46. Buber J, Mathew J, Moss AJ, Hall WJ, Barsheshet A, McNitt S, et al. Risk of recurrent cardiac events after onset of menopause in women with congenital long-QT syndrome types 1 and 2. Circulation. 2011;123:2784–91.

    Article  Google Scholar 

  47. Huang AJ, Sawaya GF, Vittinghoff E, Lin F, Grady D. Hot flushes, coronary heart disease, and hormone therapy in postmenopausal women. Menopause. 2009;16:639–43.

    Article  CAS  Google Scholar 

  48. Szmuilowicz ED, Manson JE, Rossouw JE, Howard BV, Margolis KL, Greep NC, et al. Vasomotor symptoms and cardiovascular events in postmenopausal women. Menopause. 2011;18:603–10.

    Article  Google Scholar 

  49. Thurston RC, Johnson BD, Shufelt CL, et al. Menopausal symptoms and cardiovascular disease mortality in the women’s ischemia syndrome evaluation (WISE). Menopause. 2017;24:126–32.

    Article  Google Scholar 

  50. Freedman RR. Objective or subjective measurement of hot flashes in clinical trials: quo vadis. Maturitas. 2010;67:99–100.

    Article  Google Scholar 

  51. Fu P, Matthews KA, Thurston RC. How well do different measurement modalities estimate the number of vasomotor symptoms? Findings from the study of women’s health across the nation FLASHES study. Menopause. 2014;21:124–30.

    Article  Google Scholar 

  52. Miller VM, Kling JM, Files JA, Joyner MJ, Kapoor E, Moyer AM, et al. What’s in a name: are menopausal “hot flashes” a symptom of menopause or a manifestation of neurovascular dysregulation? Menopause. 2018;25:700–3.

    Article  Google Scholar 

  53. Thurston RC, Chang Y, Barinas-Mitchell E, Jennings JR, von Känel R, Landsittel DP, et al. Menopausal hot flashes and carotid intima media thickness among midlife women. Stroke. 2016;47:2910–5.

    Article  Google Scholar 

  54. Thurston RC, Chang Y, Barinas-Mitchell E, Jennings JR, von Känel R, Landsittel DP, et al. Physiologically assessed hot flashes and endothelial function among midlife women. Menopause. 2017;24:886–93.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Helsinki, Helsinki, Finland

    Pauliina Tuomikoski & Hanna Savolainen-Peltonen

  2. Eira Hospital and Medical Center, Helsinki, Finland

    Pauliina Tuomikoski

  3. Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland

    Hanna Savolainen-Peltonen

Authors
  1. Pauliina Tuomikoski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hanna Savolainen-Peltonen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pauliina Tuomikoski .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Zaragoza Facultad de Medicina, Zaragoza, Spain

    Faustino R. Pérez-López

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Tuomikoski, P., Savolainen-Peltonen, H. (2019). Vasomotor Symptoms, Metabolic Syndrome, and Cardiovascular Risks. In: Pérez-López, F. (eds) Postmenopausal Diseases and Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-13936-0_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-13936-0_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-13935-3

  • Online ISBN: 978-3-030-13936-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation