Hypertensive disorders of pregnancy a risk factor for hot flashes

A history of hypertensive disorders of pregnancy holds excess risk of problematic hot flashes, as reported in a study from Japan.

Using data from the Japan Nurses’ Health Study, the study included 4,627 women aged 41–55 years at baseline who were parous. All women completed a 4-year follow-up questionnaire, the Climacteric Symptom Checklist for Japanese Women, to assess the main outcome of self-reported problematic hot flashes. The questionnaire was developed by a subcommittee of the Japan Society of Obstetrics and Gynecology.

At baseline, 610 (13.2 percent) women reported a history of hypertensive disorders of pregnancy. At the 4-year follow-up survey, 394 (8.5 percent) women reported problematic hot flashes, 529 (11.4 percent) received a diagnosis of premenopausal hypertension, and 2,389 (51.5 percent) were postmenopausal.

Multivariable logistic regression analysis showed an association between a history of hypertensive disorders of pregnancy and problematic hot flashes. Women with vs without the history had more than 40-percent higher odds of having problematic hot flashes (adjusted odds ratio [OR], 1.42, 95 percent confidence interval [CI], 1.04–1.94).

The estimate was higher in the group of women without premenopausal hypertension, where the odds of problematic hot flashes were 55 percent greater for those with vs without hypertensive disorders of pregnancy (adjusted OR, 1.55, 95 percent CI, 1.10–2.19).

Hypertensive disorders of pregnancy and vasomotor symptoms, such as hot flashes, are said to be potential manifestations of underlying vascular dysfunction in women. Understanding the association between these unique female-specific cardiovascular risk factors should help pinpoint those at higher risk and facilitate targeted and individualized risk-reduction treatment. [Menopause 2020;28:25-31]