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Lee E, Anselmo M, Tahsin CT, Vanden Noven M, Stokes W, Carter JR, Keller-Ross ML. Vasomotor symptoms of menopause, autonomic dysfunction, and cardiovascular disease. Am J Physiol Heart Circ Physiol 2022; 323:H1270-H1280. [PMID: 36367692 PMCID: PMC9744645 DOI: 10.1152/ajpheart.00477.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/18/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022]
Abstract
Cardiovascular disease (CVD), the leading cause of death among US adults, is more prevalent in menopausal females compared with age-matched males. Vasomotor symptoms of menopause (VMS; hot flashes/flushes and night sweats) are common among females undergoing menopausal transition and have been associated with elevated blood pressure (BP) and increased CVD risk. Autonomic dysregulation of BP has been posited as a contributing factor to the elevated CVD risk in menopausal females with VMS. This review includes 1) a brief overview of the relationship between VMS and CVD, 2) mechanisms of hot flushes and their potential impact on short- and long-term BP regulation, and 3) how the disruption of autonomic function associated with VMS might provide a mechanistic pathway to CVD development. Finally, this review will highlight knowledge gaps and future directions toward better understanding of hot flush physiology and VMS contributions to CVD.
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Affiliation(s)
- Emma Lee
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Miguel Anselmo
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Chowdhury Tasnova Tahsin
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota
| | | | - William Stokes
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Jason R Carter
- Department of Health and Human Development, Montana State University, Bozeman, Montana
- Robbins College of Health and Human Sciences, Baylor University, Waco, Texas
| | - Manda L Keller-Ross
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota
- Division of Rehabilitation Science, Medical School, University of Minnesota, Minneapolis, Minnesota
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Gao CC, Kapoor E, Lipford MC, Miller VM, Schroeder DR, Mara KC, Faubion SS. Association of vasomotor symptoms and sleep apnea risk in midlife women. Menopause 2018; 25:391-398. [PMID: 29088020 PMCID: PMC5866162 DOI: 10.1097/gme.0000000000001020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to determine the association between self-reported vasomotor symptoms (VMS) and obstructive sleep apnea (OSA) risk. METHODS The STOP-BANG to evaluate OSA and Menopause Rating Scale (MRS) were administered to 2,935 women seen in the Women's Health Clinic at Mayo Clinic in Rochester, MN, between May 2015 and December 2016. Of these, 1,691 women were included in the analysis. Total MRS and VMS ratings were compared using logistic regression, with age, smoking, and body mass index (BMI) included as covariates between women at intermediate/high risk versus low risk for OSA. RESULTS Total MRS scores were significantly higher in women with intermediate/high-risk OSA scores versus those with low-risk scores [mean (SD): 16.8 (8.0) vs 12.9 (7.0), P < 0.001]. Women at intermediate/high OSA risk were older, had more education, self-reported hypertension, BMI >35 kg/m, and were less likely to be married or employed. Self-reported severe/very severe VMS were significantly associated with intermediate/high risk versus low risk for OSA (26.6% vs 15.0%; P < 0.001). After adjusting for age, BMI, smoking status, and self-reported hypertension, the odds of having intermediate/high risk for OSA were 1.87 times higher for those with severe/very severe VMS compared with those with none/mild/moderate VMS (95% CI, 1.29-2.71, P < 0.001). This association persisted upon subgroup analysis based on BMI <25 kg/m (odds ratio 2.15; 95% CI, 1.12-4.16, P = 0.022). CONCLUSIONS Self-reported severe/very severe VMS were associated with intermediate/high risk for OSA in midlife women, even in women with BMI <25 kg/m. Given the limitations of the STOP-BANG tool, OSA risk may, however, have been overestimated.
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Affiliation(s)
| | - Ekta Kapoor
- Women’s Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN
- Division of Endocrinology, Metabolism and Nutrition, Mayo Clinic, Rochester, MN
| | - Melissa C. Lipford
- Center for Sleep Medicine and Department of Neurology, Mayo Clinic, Rochester, MN
| | - Virginia M. Miller
- Women’s Health Research Center, Mayo Clinic, Rochester, MN
- Departments of Surgery and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN
| | - Darrell R. Schroeder
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Kristin C. Mara
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Stephanie S. Faubion
- Women’s Health Clinic, Division of General Internal Medicine, Mayo Clinic, Rochester, MN
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Auro K, Joensuu A, Fischer K, Kettunen J, Salo P, Mattsson H, Niironen M, Kaprio J, Eriksson JG, Lehtimäki T, Raitakari O, Jula A, Tiitinen A, Jauhiainen M, Soininen P, Kangas AJ, Kähönen M, Havulinna AS, Ala-Korpela M, Salomaa V, Metspalu A, Perola M. A metabolic view on menopause and ageing. Nat Commun 2014; 5:4708. [PMID: 25144627 DOI: 10.1038/ncomms5708] [Citation(s) in RCA: 173] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 07/16/2014] [Indexed: 12/12/2022] Open
Abstract
The ageing of the global population calls for a better understanding of age-related metabolic consequences. Here we report the effects of age, sex and menopause on serum metabolites in 26,065 individuals of Northern European ancestry. Age-specific metabolic fingerprints differ significantly by gender and, in females, a substantial atherogenic shift overlapping the time of menopausal transition is observed. In meta-analysis of 10,083 women, menopause status associates with amino acids glutamine, tyrosine and isoleucine, along with serum cholesterol measures and atherogenic lipoproteins. Among 3,204 women aged 40-55 years, menopause status associates additionally with glycine and total, monounsaturated, and omega-7 and -9 fatty acids. Our findings suggest that, in addition to lipid alterations, menopause may contribute to future metabolic and cardiovascular risk via influencing amino-acid concentrations, adding to the growing evidence of the importance of amino acids in metabolic disease progression. These observations shed light on the metabolic consequences of ageing, gender and menopause at the population level.
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Affiliation(s)
- Kirsi Auro
- 1] Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Biomedicum 1, Haartmaninkatu 8, Helsinki 00290, Finland [2] Institute for Molecular Medicine (FIMM), University of Helsinki, Biomedicum 2, Tukholmankatu 8, Helsinki 00290, Finland [3] Department of Obstetrics and Gynecology, Helsinki University Central Hospital and University of Helsinki, Haartmaninkatu 2, Helsinki 00290, Finland [4]
| | - Anni Joensuu
- 1] Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Biomedicum 1, Haartmaninkatu 8, Helsinki 00290, Finland [2] Institute for Molecular Medicine (FIMM), University of Helsinki, Biomedicum 2, Tukholmankatu 8, Helsinki 00290, Finland [3]
| | - Krista Fischer
- Estonian Genome Center, University of Tartu, Riia 23b, Tartu 51010, Estonia
| | - Johannes Kettunen
- 1] Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Biomedicum 1, Haartmaninkatu 8, Helsinki 00290, Finland [2] Institute for Molecular Medicine (FIMM), University of Helsinki, Biomedicum 2, Tukholmankatu 8, Helsinki 00290, Finland [3] Computational Medicine, Institute of Health Sciences, University of Oulu, Pentti Kaiteran katu 1, Oulu 90570, Finland
| | - Perttu Salo
- 1] Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Biomedicum 1, Haartmaninkatu 8, Helsinki 00290, Finland [2] Institute for Molecular Medicine (FIMM), University of Helsinki, Biomedicum 2, Tukholmankatu 8, Helsinki 00290, Finland
| | - Hannele Mattsson
- 1] Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Biomedicum 1, Haartmaninkatu 8, Helsinki 00290, Finland [2] Institute for Molecular Medicine (FIMM), University of Helsinki, Biomedicum 2, Tukholmankatu 8, Helsinki 00290, Finland
| | - Marjo Niironen
- Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Biomedicum 1, Haartmaninkatu 8, Helsinki 00290, Finland
| | - Jaakko Kaprio
- 1] Institute for Molecular Medicine (FIMM), University of Helsinki, Biomedicum 2, Tukholmankatu 8, Helsinki 00290, Finland [2] Departmentof Public Health, Hjelt Institute, University of Helsinki, PO Box 41 Mannerheimintie 172, Helsinki 00014, Finland [3] Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PO Box 30 (Mannerheimintie 166), Helsinki 00300, Finland
| | - Johan G Eriksson
- 1] Chronic Disease Epidemiology and Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Mannerheimintie 166, Helsinki 00300, Finland [2] Department of General Practice and Primary Health Care, University of Helsinki, PL 20, Tukholmankatu 8B, Helsinki 00029, Finland [3] Vasa Central Hospital, Sandviksgatan 2-4, Vasa 65130, Finland [4] Folkhälsan Research Centre, Helsingfors Universitet, PB 63, Helsinki 00014, Finland [5] Unit of General Practice, Helsinki University Central Hospital, Haartmaninkatu 4, Helsinki 00290, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, University of Tampere School of Medicine, Tampere University, Kalevantie 4, Tampere 33014, Finland
| | - Olli Raitakari
- Department of Clinical Physiology and Nuclear Medicine, Research Centre of Applied and Preventive Cardiovascular Medicine, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, Turku 20521, Finland
| | - Antti Jula
- Chronic Disease Epidemiology and Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Mannerheimintie 166, Helsinki 00300, Finland
| | - Aila Tiitinen
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital and University of Helsinki, Haartmaninkatu 2, Helsinki 00290, Finland
| | - Matti Jauhiainen
- 1] Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Biomedicum 1, Haartmaninkatu 8, Helsinki 00290, Finland [2] Institute for Molecular Medicine (FIMM), University of Helsinki, Biomedicum 2, Tukholmankatu 8, Helsinki 00290, Finland
| | - Pasi Soininen
- 1] Computational Medicine, Institute of Health Sciences, University of Oulu, Pentti Kaiteran katu 1, Oulu 90570, Finland [2] NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 PL 1627, Kuopio 70211, Finland
| | - Antti J Kangas
- 1] Computational Medicine, Institute of Health Sciences, University of Oulu, Pentti Kaiteran katu 1, Oulu 90570, Finland [2] NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 PL 1627, Kuopio 70211, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and University of Tampere School of Medicine, Tampere University, Kalevantie 4, Tampere 33014, Finland
| | - Aki S Havulinna
- Chronic Disease Epidemiology and Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Mannerheimintie 166, Helsinki 00300, Finland
| | - Mika Ala-Korpela
- 1] Computational Medicine, Institute of Health Sciences, University of Oulu, Pentti Kaiteran katu 1, Oulu 90570, Finland [2] NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Yliopistonranta 1 PL 1627, Kuopio 70211, Finland [3] Oulu University Hospital, Kajaanintie 50, Oulu 90220, Finland [4] Computational Medicine, School of Social and Community Medicine and Medical Research Council Integrative Epidemiology Unit, University of Bristol, Senate House, Tyndall Avenue, Bristol, City of Bristol BS8 1TH, UK
| | - Veikko Salomaa
- Chronic Disease Epidemiology and Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Mannerheimintie 166, Helsinki 00300, Finland
| | - Andres Metspalu
- Estonian Genome Center, University of Tartu, Riia 23b, Tartu 51010, Estonia
| | - Markus Perola
- 1] Public Health Genomics Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Biomedicum 1, Haartmaninkatu 8, Helsinki 00290, Finland [2] Institute for Molecular Medicine (FIMM), University of Helsinki, Biomedicum 2, Tukholmankatu 8, Helsinki 00290, Finland [3] Estonian Genome Center, University of Tartu, Riia 23b, Tartu 51010, Estonia
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Bakouei F, Basirat Z, Salmalian H, Omidvar S, Bakouei S. Assessment of women's awareness level about symptoms and complications of menopause and methods to their prevention. ACTA ACUST UNITED AC 2013. [DOI: 10.5339/jlghs.2013.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Context: Since menopause age is constant, an increase in life expectancy has resulted in an increase of the menopause period in women. Aims: This study was done to assess women's awareness level about symptoms and complications of menopause and methods of their prevention. Settings and design: This cross-sectional research was conducted on 220 women, 40 years of age or older referrals in selected health care centers. Methods and material: The research was conducted using a questionnaire with regular random sampling method. Statistical analysis used: The analysis of obtained findings was done by SPSS statistical software and statistical tests. Results: Based on their total score, 48.6% of women had good awareness, 24.1% of them had average awareness, and 27.3% of them had low awareness. Eighty-five percent of the participants had read or heard some topics about menopause from their relatives (26.8%), friends (25.5%), health care staffs (20%), books and journals (10.5%), and television or radio (8.6%). Women's awareness level had significant correlation with child number, job, education, income, hearing or reading text about menopause and their informational source, but awareness did not have significant correlation with age and being menopausal. Conclusions: Based on the findings of this study, the rate of participants' correct answers was lower than 50%. Key message: It is suggested to enhance women's awareness level through all sources including television, radio, journals, newspaper and medical staffs, since education is the most important tool in any prevention programs.
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Affiliation(s)
- Fatemeh Bakouei
- 1Reproductive Health, Department of Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Basirat
- 2Department of Obstetrics and Gynecology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Hajar Salmalian
- 3Fatemeh Zahra Infertility and Reproductive Health Research Center, Department of Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Shabnam Omidvar
- 4Reproductive Health, Department of Midwifery, Babol University of Medical Sciences, Babol, Iran
| | - Sareh Bakouei
- 5MSc of Midwifery, Qom University of Medical Sciences, Qom, Iran
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