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There is a significant association between unfavorable cardiovascular health metrics and an increased incidence of early-onset vasomotor symptoms in perimenopausal women.

The majority of menopausal symptoms are vasomotor symptoms that include night sweats and hot flashes. There is an increase in the incidence and prevalence of cardiovascular disease (CVD) in menopausal transition, which is due to lower levels of endogenous estrogen. The maintenance of ideal cardiovascular health (CVH) metrics is integral to decreasing CVD risk. 

This study investigated the relationship between CVH metrics and early-onset vasomotor symptoms among perimenopausal women. The study’s findings are published in The Journal of Clinical Endocrinology and Metabolism

Study Characteristics

There were a total of 2541 participants in this cohort study, with a mean age of 44.6 ± 2.3 years. The proportions of ideal, poor, and intermediate CVH groups in the study population were 56.3%, 3.8%, and 39.9%, respectively.

Cardiovascular Health Metrics and Early-Onset Vasomotor Symptoms

During the follow-up period, 1241 perimenopausal women experienced incident early-onset vasomotor symptoms. The poor and intermediate CVH groups had unadjusted hazard ratios of 1.54 and 1.06 for early-onset vasomotor symptoms, respectively, compared to perimenopausal women in the ideal CVH group. Compared to perimenopausal women having ideal CVH metrics, women in the poor CVH group had significantly adjusted hazard ratios of 1.65 and 1.35 for hot flashes and night sweats, respectively.

Severity of Vasomotor Symptoms and Cardiovascular Health Metrics

Compared to perimenopausal women with ideal CVH metrics, women with poor and intermediate CVH had significantly higher unadjusted hazard ratios of 1.79 and 1.28 for developing moderate or severe vasomotor symptoms, respectively. The results indicate that women with poor baseline CVH metrics tend to have early-onset, moderate, or severe vasomotor symptoms sooner compared to perimenopausal women with ideal CVH metrics.

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Vasomotor Symptoms and Components of Cardiovascular Health Metrics

Following the adjustment for confounders, a lower risk for the development of early-onset vasomotor symptoms was significantly and independently associated with normal body mass index, normal blood pressure, and non-smoking status. Moreover, there was a positive association between early-onset vasomotor symptom risk and moderate/high physical activity.


Choi, H. J., Chang, Y., Kim, Y., Cho, Y., Kang, J., Kwon, M. S., Kwon, R., Lim, G., Kim, K., Kim, H., Hong, Y., Park, J., Zhao, D., Cho, J., Guallar, E., Park, D. H., & Ryu, S. (2022). Ideal cardiovascular health Metrics and Risk of Incident Early-Onset vasomotor Symptoms among premenopausal women. The Journal of Clinical Endocrinology and Metabolism, 107(9), 2666–2673. https://doi.org/10.1210/clinem/dgac327