Jennifer L Gordon1, David R Rubinow, Rebecca C Thurston, Julia Paulson, Peter J Schmidt, Susan S Girdler. 1. 1Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 2Departments of Psychiatry, Epidemiology and Psychology, University of Pittsburgh, PA 3Section on Behavioral Endocrinology, Department of Health and Human Services, National Institute of Mental Health, Bethesda, MD.
Abstract
OBJECTIVE: Vasomotor symptoms (VMS) may be associated with an increased risk of cardiovascular disease. One candidate mechanism may involve alterations in physiological responses to stress. The current study therefore examined the relationship between self-reported VMS bother and cardiovascular, hemodynamic, neuroendocrine, and inflammatory responses to an acute psychosocial stress protocol. METHODS: One hundred eighty-six women in the menopausal transition or early postmenopausal stage (age 45-60 y) provided the data for this article. Subjective hot flash and night sweat bother were assessed using the Greene Climacteric Scale. Women also underwent a stressor battery involving a speech and a mental arithmetic task while cardiovascular, hemodynamic, neuroendocrine, and inflammatory responses were assessed. Repeated measures regression analyses were used to examine the relationship between self-reported VMS and physiologic responses to the stressor. RESULTS: In multivariate analyses adjusting for potential confounders, self-reported hot flash bother was associated with lower overall cardiac index and stroke volume index and higher overall vascular resistance index and levels of the inflammatory cytokine interleukin-6. Hot flash bother also tended to be associated with higher overall cortisol levels and higher baseline levels of plasma norepinephrine. Night sweat bother, on the other hand, was associated with higher overall cortisol levels and tended to be associated with higher interleukin-6. CONCLUSIONS: Self-reported VMS bother is associated with an unfavorable hemodynamic and neuroendocrine profile characterized by increased hypothalamic-pituitary-adrenal axis and central sympathetic activation, inflammation, and vasoconstriction. Further research investigating this profile in relation to VMS, and the potential health implications of this association, is warranted.
OBJECTIVE: Vasomotor symptoms (VMS) may be associated with an increased risk of cardiovascular disease. One candidate mechanism may involve alterations in physiological responses to stress. The current study therefore examined the relationship between self-reported VMS bother and cardiovascular, hemodynamic, neuroendocrine, and inflammatory responses to an acute psychosocial stress protocol. METHODS: One hundred eighty-six women in the menopausal transition or early postmenopausal stage (age 45-60 y) provided the data for this article. Subjective hot flash and night sweat bother were assessed using the Greene Climacteric Scale. Women also underwent a stressor battery involving a speech and a mental arithmetic task while cardiovascular, hemodynamic, neuroendocrine, and inflammatory responses were assessed. Repeated measures regression analyses were used to examine the relationship between self-reported VMS and physiologic responses to the stressor. RESULTS: In multivariate analyses adjusting for potential confounders, self-reported hot flash bother was associated with lower overall cardiac index and stroke volume index and higher overall vascular resistance index and levels of the inflammatory cytokine interleukin-6. Hot flash bother also tended to be associated with higher overall cortisol levels and higher baseline levels of plasma norepinephrine. Night sweat bother, on the other hand, was associated with higher overall cortisol levels and tended to be associated with higher interleukin-6. CONCLUSIONS: Self-reported VMS bother is associated with an unfavorable hemodynamic and neuroendocrine profile characterized by increased hypothalamic-pituitary-adrenal axis and central sympathetic activation, inflammation, and vasoconstriction. Further research investigating this profile in relation to VMS, and the potential health implications of this association, is warranted.
Authors: Emily D Szmuilowicz; JoAnn E Manson; Jacques E Rossouw; Barbara V Howard; Karen L Margolis; Nancy C Greep; Robert G Brzyski; Marcia L Stefanick; Mary Jo O'Sullivan; Chunyuan Wu; Matthew Allison; Diederick E Grobbee; Karen C Johnson; Judith K Ockene; Beatriz L Rodriguez; Gloria E Sarto; Mara Z Vitolins; Ellen W Seely Journal: Menopause Date: 2011-06 Impact factor: 2.953
Authors: D R Meldrum; J D Defazio; Y Erlik; J K Lu; A F Wolfsen; H E Carlson; J M Hershman; H L Judd Journal: Obstet Gynecol Date: 1984-12 Impact factor: 7.661
Authors: Siobán D Harlow; Margery Gass; Janet E Hall; Roger Lobo; Pauline Maki; Robert W Rebar; Sherry Sherman; Patrick M Sluss; Tobie J de Villiers Journal: Climacteric Date: 2012-02-16 Impact factor: 3.005
Authors: Kristen E Gray; Jodie G Katon; Erin S LeBlanc; Nancy F Woods; Lori A Bastian; Gayle E Reiber; Julie C Weitlauf; Karin M Nelson; Andrea Z LaCroix Journal: Menopause Date: 2018-05 Impact factor: 2.953
Authors: Ellen B Gold; Guibo Xing; Nancy E Avis; Sioban Harlow; Hadine Joffe; Karen Matthews; Jelena M Pavlovic; Rebecca C Thurston; Elaine Waetjen Journal: Menopause Date: 2022-08-01 Impact factor: 3.310
Authors: Ekta Kapoor; Madison Okuno; Virginia M Miller; Liliana Gazzuola Rocca; Walter A Rocca; Juliana M Kling; Carol L Kuhle; Kristin C Mara; Felicity T Enders; Stephanie S Faubion Journal: Maturitas Date: 2020-10-14 Impact factor: 4.342
Authors: Anthony S Zannas; Jennifer L Gordon; Alan L Hinderliter; Susan S Girdler; David R Rubinow Journal: J Clin Endocrinol Metab Date: 2020-10-01 Impact factor: 5.958
Authors: Jennifer L Gordon; David R Rubinow; Lana Watkins; Alan L Hinderliter; Melissa C Caughey; Susan S Girdler Journal: J Clin Endocrinol Metab Date: 2020-05-01 Impact factor: 6.134