Studies Explore Impacts of Hot Flashes, Sedentary Behavior and Antidepressant Use on CV Disease

New research on women who experience hot flashes, the link between excessive sitting and increased coronary artery calcification, and use of antidepressants, will be presented as part of ACC.15.

According to two separate studies, women who experience hot flashes earlier in life appear to have poorer endothelial function than women who have hot flashes later in life or not at all.

In the first study, researchers enrolled 189 healthy peri-or post-menopausal women and examined the relationship between hot flashes and flow-mediated dilation. Results showed that more hot flashes over a 24-hour period were associated with significantly lower flow-mediated dilation and, therefore, poorer endothelial function in younger women, ages 52 and younger. Further, having any number of hot flashes at a younger age was related to a three percent reduction in flow-mediated dilation compared to the younger women with no symptoms.

The second study confirms these findings and evaluated 104 post-menopausal women with an average age of 67 who were enrolled in the Women’s Ischemic Syndrome Evaluation study. The study found that women who had early onset hot flashes had significantly lower flow-mediated dilation suggesting poorer endothelial function compared with women whose symptoms started later.

According to Rebecca C. Thurston, PhD, associate professor of psychiatry, psychology and epidemiology, University of Pittsburgh, and lead author of both studies, “The research suggests early onset hot flashes may serve as a red flag to help identify women at greater cardiovascular risk who could benefit from more aggressive risk reduction early in midlife.”

Exploring the link between sedentary behavior and cardiovascular disease, a separate study analyzed heart scans and physical activity records of more than 2,000 adults living in Dallas. Researchers found each hour of sedentary time per day on average was associated with a 14 percent increase in coronary artery calcification burden. The association was independent of exercise activity and other traditional cardiovascular disease risk factors.

“This study suggests that reducing how much you sit every day may represent a more novel, companion strategy (in addition to exercise) to help reduce your cardiovascular risk,” said Jacquelyn Kulinski, MD, assistant professor of cardiovascular medicine at the Medical College of Wisconsin and the study’s lead author.

Meanwhile, a separate study explored the use of antidepressants and its impact on cardiovascular disease.  Researchers at the Intermountain Medical Center Heart Institute in Salt Lake City analyzed the health records and rates of death, coronary artery disease and stroke of more than 26,000 patients treated in the statewide network of health centers over a three-year period. Based on a depression screening questionnaire, researchers identified 5,311 patients as having moderate to severe depression and 21,517 patients as having no to mild depression.

Results showed that patients with moderate to severe depression who took antidepressants alone had a lower risk of death, coronary artery disease and stroke than patients with moderate to severe depression who did not take antidepressant or statin medications. Further, taking statins alone or in combination with antidepressants was not associated with a significant risk reduction in this group of patients.

“This study adds to the evidence that, when used properly, antidepressants can improve cardiovascular outcomes among those with depressive symptoms,” said Heidi May, PhD, MSPH, a cardiovascular epidemiologist at the Intermountain Medical Center Heart Institute, Salt Lake City, and the study’s lead author.

Clinical Topics: Diabetes and Cardiometabolic Disease, Dyslipidemia, Atherosclerotic Disease (CAD/PAD), Nonstatins, Novel Agents, Statins

Keywords: ACC Annual Scientific Session, Antidepressive Agents, Cardiovascular Diseases, Coronary Artery Disease, Coronary Disease, Cost of Illness, Depression, Depressive Disorder, Depressive Disorder, Major, Hot Flashes, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Psychiatry, Risk Factors, Risk Reduction Behavior, Sedentary Behavior, Stroke

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