Menopausal hot flashes are more dangerous than previously thought, studies say

The heat wave comes out of nowhere, so strong for some that their faces burn and sweat pours from every pore on their bodies. Welcome to hot flashes and other symptoms of approaching menopause — an experience that experts say about 75 percent of women will share if they live long enough.

Even if menopause is still years or decades away, now is the time to pay attention — because, according to emerging science, the menopause experience can be detrimental to your future health.

Unpublished studies presented Wednesday at the annual meeting of The Menopause Society in Philadelphia found that intense hot flashes are associated with an increase in C-reactive protein, which is a marker of future heart disease. and to a blood biomarker that can predict a later diagnosis of Alzheimer’s disease.

“This is the first time science has shown that hot flashes are linked to blood biomarkers of Alzheimer’s disease,” said Dr. Stephanie Faubion, director of the Mayo Clinic Women’s Health Specialty Clinic in Jacksonville, Florida, and medical director of The Menopause Society.

“This is more evidence that tells us that hot flashes and night sweats may not be as benign as we thought they were in the past,” said Faubion, who was not involved in the studies.

Alzheimer’s risk

Nearly 250 women ages 45 to 67 with menopausal symptoms used a device to objectively measure their sleep quality over three nights. The women were also fitted with sweat monitors to record hot flashes on one such night.

The researchers then collected blood samples from the study participants and examined them for a specific protein biomarker of Alzheimer’s disease called beta-amyloid 42/40.

“Beta-amyloid 42/40 is considered a marker of amyloid plaques in the brain, which is one of the components of the pathophysiology of Alzheimer’s disease dementia,” said the study’s lead author, Dr. Rebecca Thurston.

“We found that night sweats were associated with adverse beta-amyloid 42/40 profiles, indicating that hot flashes experienced during sleep may be a marker of women at risk for Alzheimer’s dementia,” said Thurston, professor of psychiatry, epidemiology and psychology who directs the Women’s Biobehavioral Health Laboratory at Pitt Public Health at the University of Pittsburgh.

The biomarker does not identify whether a person has clinical Alzheimer’s disease, Thurston said, only the possibility of developing the disease in the future.

“In other words, nighttime heat waves do not cause this risk. They are just a marker of people who are at higher risk,” Faubion said. “Similarly, we don’t know whether treating night sweats would reduce the risk. We don’t know that.”

The study also looked at two biomarkers for tau protein, another hallmark of Alzheimer’s disease, but found no association, Thurston said. “These biomarkers are still in rapid development, and although they have already been validated, there is still more we need to learn.”

Due to objective sleep measurements, the researchers were able to rule out the role of poor sleep, a well-known risk factor for dementia, in the findings. Previous research that also tracked sleep found that hot flashes and night sweats were linked to poor memory performance and changes in brain structure, function and connectivity.

“All of the findings converge to underline that there is something about these nocturnal vasomotor symptoms, beyond sleep itself, that is affecting the brain,” she said.

Heart disease

Another study presented at the conference by Thurston’s team looked at inflammatory markers for heart disease. Previous research by Thurston found that women who said they had frequent or persistent hot flashes during early menopause had a 50% to 80% increased risk of cardiovascular events such as heart attacks, stroke and heart failure.

Frequent moderate to severe heat waves can last seven to 10 years, on average, and less frequent or less severe heat waves can last even longer, according to experts.

In this new research, scientists used sweat monitors on 276 women who were part of the MSHeart study to measure the frequency and intensity of hot flashes more objectively during the day and night.

“Many people underestimate their hot flashes, saying they aren’t having many, when in fact they are,” Faubion said. “Using this monitor is an objective way to quantify them.”

The researchers compared the frequency and intensity of hot flashes with blood measurements of C-reactive protein, a protein that indicates levels of inflammation in the body and is used to determine the risk of heart disease and stroke in people who do not already have the disease. cardiac.

The results showed that daytime hot flashes were associated with higher levels of C-reactive protein, even after adjusting for other potential causes, such as age, body mass index (BMI), education, ethnicity, estradiol hormone, and race. .

“This is the first study to examine physiologically measured hot flashes in relation to inflammation and adds evidence to a growing body of literature that suggests hot flashes may signify underlying vascular risk,” said lead author Mary Carson, a clinical doctoral student. and biohealth in the psychology department at the University of Pittsburgh.

What can you do

Since heart disease is the leading cause of death for women worldwide, doctors should start asking patients about their experiences with hot flashes as a risk factor for future illness, Faubion said.

“Women who may experience night sweats in particular may need to evaluate their cardiovascular risk in general,” she said.

“As for what to do, the recommendations will be the same as for heart and brain health: better sleep, adequate nutrition, a regular exercise program, reducing stress, staying socially connected and doing something that stimulates the brain.”