Vasomotor Symptoms and Lipid Profiles in Women Transitioning Through Menopause

OBJECTIVE: To examine associations between vasomotor symptoms and lipids over 8 years, controlling for other cardiovascular risk factors, estradiol, and follicle-stimulating hormone. METHODS: Study of Women's Health Across the Nation participants (N = 3,201), aged 42-52 years at entry, completed interviews on frequency of hot flushes and night sweats (none, 1-5 days, 6 days or more, in the past 2 weeks) physical measures (blood pressure, height, weight), and blood draws (low-density lipoprotein [LDL], high-density lipoprotein [HDL], apolipoprotein A-1, apolipoprotein B, lipoprotein[a], triglycerides, serum estradiol, follicle-stimulating hormone) yearly for 8 years. Relations between symptoms and lipids were examined in linear mixed models adjusting for cardiovascular risk factors, medications, and hormones. RESULTS: Compared with no flushes, experiencing hot flushes was associated with significantly higher LDL (1-5 days: beta [standard error]=1.48 [0.47], P<.01; 6 days or more: beta [standard error]= 2.13 [0.62], P<.001), HDL (1-5 days: beta [standard error]=0.30 [0.18]; 6 days or more: beta [standard error]=0.77 [0.24], P<.01), apolipoprotein A-1 (1-5 days: beta [standard error]=0.92 [0.47], P<.10; 6 days or more: beta [standard error] beta 1.97 [0.62], P<.01), apolipoprotein B (1-5 days: beta [standard error]=1.41 [0.41], P<.001; 6 days or more: beta [standard error]=2.51 [0.54], P<.001), and triglycerides (1-5 days: percent change [95% confidence interval]=2.91 [1.41-4.43], P<.001; 6 days or more: percent change [95% confidence interval[=5.90 [3.86-7.97], P<.001) in multivariable models. Findings largely persisted adjusting for hormones. Estimated mean differences in lipid levels between hot flushes 6 days or more compared with no days ranged from less than 1 (for HDL) to 10 mg/dL (for triglycerides). Night sweats were similar. Associations were strongest for lean women. CONCLUSION: Vasomotor symptoms were associated with higher LDL, HDL, apolipoprotein A-1, apolipoprotein B, and triglycerides. Lipids should be considered in links between hot flushes and cardiovascular risk. (Obstet Gynecol 2012;119:753-61) DOI: 10.1097/AOG.0b013e31824a09ec