Vascular function and cardiovascular risk factors in women with severe flushing

Sassarini, J., Fox, H., Ferrell, W., Sattar, N. and Lumsden, M.A. (2011) Vascular function and cardiovascular risk factors in women with severe flushing. Clinical Endocrinology, 74(1), pp. 97-103. (doi: 10.1111/j.1365-2265.2010.03921.x)



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Background: Seventy per cent of postmenopausal women suffer from hot flushes causing significant morbidity in 25%. Oestrogen replacement provides symptom relief, but its use has declined following safety issues and there is, as yet, no good alternative. Pathophysiology is poorly understood, but one proposed mechanism is altered peripheral vascular reactivity. It has recently been suggested that the presence of flushing may be a marker of underlying cardiovascular risk. <p/>Aim: To measure (i) peripheral vascular reactivity in subcutaneous vessels (ii) routine and novel cardiovascular risk factors in postmenopausal women who flush, and compare results to a matched group of women who do not flush. <p/>Methods: Thirty-two postmenopausal women with at least 20 flushes/week and 14 nonflushing postmenopausal women were recruited. Cutaneous microvascular perfusion was measured using laser Doppler imaging, and endothelial function was assessed by iontophoresis (administration of vasoactive agents through the skin by an electric current) of acetylcholine [Ach] (endothelial-dependent) and sodium nitroprusside [SNP] (endothelial independent). Blood samples for risk factors were taken following vascular assessment. <p/>Results: Both study groups were well matched demographically. The response of the subcutaneous vessels was greater in women who flushed than those who did not, following administration of both the endothelium-dependent and independent vasodilators, (ACh, P ≤ 0·001, SNP, P = 0·001, 2-way anova). By contrast, levels of High Density Lipoprotein (HDL)-cholesterol and ApoA1 were significantly lower in the flushing women compared with the control women (P = 0·02 and 0·002, respectively), and levels of inter-cellular adhesion molecule-1 (ICAM-1) were higher (P = 0·03), findings robust to adjustment for confounders, suggesting an adverse cardiovascular risk profile. <p/>Conclusion: These results confirm a better vascular response in women but paradoxically, such women appear to have worse (not better) cardiovascular disease risk factors in particular lower HDL-cholesterol but also higher non-HDL-c to HDL-c ratio and increased ICAM-1. Further studies are needed to assess vascular risk factors in women who flush.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Ferrell, Professor William and Sassarini, Dr Jenifer and Lumsden, Professor Mary and Sattar, Professor Naveed
Authors: Sassarini, J., Fox, H., Ferrell, W., Sattar, N., and Lumsden, M.A.
Subjects:R Medicine > RG Gynecology and obstetrics
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Infection & Immunity
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:Clinical Endocrinology
Publisher:Wiley-Blackwell Publishing, Society for Endocrinology
ISSN (Online):1365-2265
Published Online:15 December 2010
Copyright Holders:Copyright © 2010 Blackwell Publishing Ltd.
First Published:First published in Clinical Endocrinology 2010 74(1):97-103
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
500661The Aetiology of Hot Flushing in Postmenopausal Women and Hypogonadal MenMary LumsdenWellbeing of Women (WELLBEING)RG1074MVLS MED - REPRODUCTIVE & MATERNAL MED