Hot Flashes, Yes, But No Heart Disease

Cardiovascular disease risk not affected by menopausal status

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) An unhealthy diet can lead to heart disease. Being overweight, smoking and not exercising can also bring on the condition. What about adding menopause to the mix?

A new study showed that women's heart disease risk was not affected by menopause nor by having a hysterectomy with or without removing the ovaries during middle age.

These findings can reassure women and their doctors that having a hysterectomy (a procedure to remove the uterus and possibly the ovaries) is not likely to increase their chances of developing heart disease, according to the researchers.

"Maintain an active, balanced lifestyle no matter your age."

The aim of this study, led by Karen Matthews, PhD, from the Departments of Psychiatry and Epidemiology at the University of Pittsburgh, was to see how cardiovascular disease (CVD) risk in middle-aged women was affected after menopause or having a hysterectomy to remove her uterus.

CVD, or heart disease, is a range of diseases that affect the heart and can lead to chest pain, heart attacks or strokes. 

The study included 3,302 premenopausal women who were enrolled between 1996 and 2008 in the Study of Women's Health across the Nation (SWAN), which follows women early in their menopausal transition.

The women were between 42 and 52 years of age, were not on hormone therapy and had at least one period in the three months prior to being recruited at different sites across the US. 

Patients' lifestyle factors, medication use and menopausal status were tracked. Women were categorized as premenopausal (including early perimenopause), perimenopausal (late perimenopause), unknown or missing.

In this study, premenopause meant having a period in the last three months with no previous menstrual cycle irregularity.

Women in early perimenopause had some irregularity in cycle during the last year, with bleeding in the last three months. Women in late perimenopause had a period more than three months ago but within the last year. 

The researchers also made note of the women's previous surgeries, insulin resistance, blood pressure and body mass index (a measure of their height and weight).

To assess heart disease risk, women had their blood drawn at each site visit after fasting to measure their blood glucose, cholesterol and insulin levels.

By 2008, 1,769 women reached menopause naturally. At the same time, 77 women had had a hysterectomy with their ovaries preserved and 106 women had had the procedure with their ovaries removed.

Factors that determine cardiovascular disease risk did not change overall in each group, the researchers found. In addition, women's ethnicity did not affect their heart disease risk.

"Several CVD risk factor changes did differ during the intervals prior to and following hysterectomy, compared to the changes prior to and following [final menstrual period], but not in a pattern suggesting increasing cardiovascular risk following hysterectomy," the researchers wrote in their report.

The researchers noted that there were few women in their study who had had a hysterectomy and their ovaries removed, and the findings could not be generalized to younger women since they only studied older premenopausal women.

The impact of surgery in the long term also was not assessed.

All the women had elected to have the surgery.

The study was published online May 14 in the Journal of the American College of Cardiology.

Funding for the study was provided by the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
May 14, 2013
Last Updated:
August 13, 2013