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DEAR MAYO CLINIC: I’m 50 years old and recently started having menopause symptoms, including a lot of hot flashes. Is it true that frequent hot flashes could be a sign of heart disease? Should I see my health care provider to get my heart checked?
ANSWER: A direct association between hot flashes and heart disease hasn’t been found. However, research suggests that women who have hot flashes may be at a higher risk of having heart problems in the future than women who don’t have them. It would be a good idea for you to talk with your health care provider about your hot flashes and assess your risk for heart disease overall.
Hot flashes — sudden feelings of warmth, often over your face, neck and chest — are a common menopause symptom. The exact cause of hot flashes during the transition into menopause isn’t clear. They seem to be related to changes in reproductive hormones and the way your body responds to slight variations in temperature.
A recent study of women 40 to 60 looked at the connection between hot flashes and vascular health, particularly the health of blood vessels. It found that women who have hot flashes, especially younger women who have them early in the transition into menopause, have arteries that are less likely to relax appropriately during exercise or stress. In other words, their arteries were stiffer than normal. Specifically, the researchers focused on flow-mediated dilation — the way an artery widens when blood flow increases to that artery. In the women who had hot flashes, flow-mediated dilation did not tend to work properly. That could put those women at risk for future cardiovascular problems, including heart disease.
It’s important to keep in mind that these findings do not necessarily link heart disease and hot flashes. Having hot flashes does not mean you’re going to have a heart attack. Instead, it indicates that some of your arteries may not be working as well as they should. Knowing that can help you and your health care provider better assess your overall risk for heart disease and other cardiovascular problems.
It is worth remembering that whether or not you have hot flashes isn’t something you can control. That’s not true, however, with some of the other risk factors for heart disease that are modifiable, such as smoking and obesity. Studies have shown that smoking is one of the most dangerous heart disease risk factors in women. A woman who smokes is twice as likely to have a heart attack as one who does not. Quitting smoking is one of the best ways you can lower your heart disease risk.
Obesity also puts you at higher risk of developing heart disease. Excess weight is particularly dangerous because it often triggers other medical conditions, such as diabetes, high blood pressure and high cholesterol. Each of those disorders on its own can make a person more susceptible to heart disease. A large research study showed that women who are obese experience heart attacks 11 years earlier on average than similar women who are not obese.
Heart disease is the leading cause of death in the U.S. for both women and men. But more than 80 percent of heart disease is preventable by living a heart-healthy lifestyle. That lifestyle includes eating a diet rich in fruits and vegetables, and low in saturated fats; getting regular physical activity; being at a healthy body weight; and not smoking.
Make an appointment to talk with your health care provider about your heart disease risk. Together, you can assess your situation, see if there are lifestyle adjustments you can make and create a plan to maintain your heart health. — Dr. Rekha Mankad, Women’s Heart Clinic, Mayo Clinic, Rochester, Minnesota