Evaluation of the Relationship Between Hot Flashes and Night Sweats and Severity of Coronary Artery Disease in Postmenopausal Women

Document Type: Original Article


1 Cardiologist,Heart failure Research Center, Cardiovascular Research Institute, Isfahan university of Medical Sciences, Isfahan, Iran

2 Cardiologist, Isfahan University of Medical Sciences, Isfahan, Iran

3 Nurse, Chamran Hospital, Isfahan, Iran

4 Cardiologist,Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

5 PhD of Molecular Medicine ,Endocrinology and Metabolism Research Center, Arak University of Medical Sciences, Arak, Iran


Introduction: Hot flashes (HF) and night sweats (NS) are due to vasomotor instability and could be recognized as cardiovascular risk markers. Therefore, this study aimed to evaluate the relationship between vasomotor instability and severity of coronary artery disease (CAD) in postmenopausal women.  
Materials and Methods: This observational cross sectional study, was performed in Chamran Hospital, Isfahan University of medical sciences, Isfahan, Iran from 2011-2012. In this study, womenwithin the age range of 45-60 years with angiography documented CAD were enrolled.  Participants included 25 women with hot flashes, night sweats, or both and 17 women without these symptoms, respectively. In all participants, levels of follicular stimulating hormone/luteinizinghormone (FSH/LH) were measured. The severity of CAD was calculated using Gensini score. In order to evaluate the relationship between severity of CAD and other variables, Gensini scores lower than 50 and ≥50 were considered as low and high Gensini scores, respectively. Moreover, data analysis was performed using SPSS version 15.0.
Results: Our findings demonstrated that NS and HF were not associated with severity of CAD, determined by Gensini scores (P-values>0.05). However, a significant positive relationship was observed between FSH levels and severity of CAD in all participants (P=0.048). In cases in low Gensini score group, the relationship between LH and Gensini score was negative and non-significant, while Gensini score showed a positive and non-significant relationship (P-value> 0.05).
Conclusions: No significant association was observed between vasomotor symptoms of menopause and the severity of CAD. In addition, elevated FSH levels could be considered as a marker of severity of CAD.  


1.Daley A, Stokes-Lampard H, Thomas A, Macarthur C. Exercise for vasomotor menopausal symptoms. Cochrane Database Syst Rev. 2011; 28:5-12.

2.Stearns V, Ullmer L, Lopez JF, Smith Y, Isaacs C, Hayes D. Hot flashes. Lancet.2002; 360:1851–61.

3.Bastian LA, Smith CM, Nanda K. Is this woman perimenopausal? JAMA. 2003; 289:895–902.

4.Gerber LM, Sievert LL, Warren K, Pickering TG, Schwartz JE. Hot flashes are associated with increased ambulatory systolic blood pressure. Menopause. 2007; 14:308–15.

5.Low DA, Davis SL, Keller DM, Shibasaki M, Crandall CG. Cutaneous and hemodynamic responses during hot flashes in symptomatic post-menopausal women. Menopause. 2008; 15:290–5.

6.Thurston RC, Sutton-Tyrrell K, Everson-Rose SA, Hess R, Matthews KA. Hot flashes and subclinical cardiovascular disease: findings from the Study of Women's Health Across the Nation Heart Study. Circulation. 2008; 118:1234–40.

7.Gast GC, Pop VJ, Samsioe GN, Grobbee DE, Nilsson PM, Keyzer JJ, et al. Vasomotor menopausal symptoms are associated with increased risk of coronary heart disease. Menopause. 2011; 18:146-51.

8.Rao SS, Singh M, Parkar M, Sugumaran R. Health maintenance for postmenopausal women. Am Fam Physician. 2008; 78:583-91.

9.National Institutes of Health. National Institutes of Health State-of-the-Science conference statement: management of menopause-related symptoms. Ann Intern Med. 2005; 142:1003–13.


10. Huang AJ, Sawaya GF, Vittinghoff E, Lin F, Grady D. Hot flashes, coronary heart disease, and hormone therapy in postmenopausal women. Menopause. 2009; 16:639-43.

11. Leal M, Diaz J, Serrano E, Abellan J, Carbonell LF. Hormone replacement therapy for oxidative stress in postmenopausal women with hot flashes. Obstet Gynecol. 2000; 95:804–9.

12. Leal Hernandez M, Abellan Aleman J, Carbonell Meseguer LF, Diaz Fernandez J, Garcia Sanchez FA, Martinez Selva JM. Influence of the presence of hot flashes during menopause on the metabolism of nitric oxide. Effects of hormonal replacement treatment. Med Clin (Barc). 2000; 114:41–5.

13. Dabas PC, Báncora P, Vescina CM. Optimized separation conditions of soy isoflavonoids in urine by capillary zone electrophoresis. J Capill Electrophor Microchip Technol. 2003; 8:53-8.

14. Visvanathan K, Gallicchio L, Schilling C, Babus JK, Lewis LM, Miller SR, et al. Cytochrome gene polymorphisms, serum estrogens, and hot flashes in midlife women. Obstet Gynecol. 2005; 106:1372–81.

15. Crandall CJ, Crawford SL, Gold EB. Vasomotor symptom prevalence is associated with polymorphisms in sex steroid-metabolizing enzymes and receptors. Am J Med. 2006; 119:S52–60.

16. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol. 1983; 51:606.

17. Kovalenko AN. Hypophyseal-gonadal and hypophyseal-corticoadrenal system in healthy persons and in patients with ischemic heart disease aged 60-89 years. Ter Arkh. 1988; 60:52-7.