Ambulatory blood pressure and heart rate in relation to hot flash experience among women of menopausal age

Objective : The purpose of this study was to evaluate whether ambulatory blood pressure and heart rate varied with hot flash experience among women of menopausal age. Subjects and methods : A total of 1149 ambulatory blood pressure and heart rate measurements from 20 women aged 44-55 were examined. Women were categorized by hot flash experience as (1) having had hot flashes during the study period (Symptomatic during Study; n = 5; 302 measurements), (2) having a past history of hot flashes, but no hot flashes during the study period (Historically Symptomatic; n = 7; 385 measurements), and (3) never having had a hot flash (Asymptomatic; n = 8; 462 measurements). Using repeated measures, nested ANOVA models that also adjusted for posture, the variation in blood pressure and heart rate associated with hot flash experience over the whole day and by location of measurement (microenvironment) was evaluated. Results : The results show that, overall, systolic pressure did not differ among the hot flash experience groups although the Symptomatic during Study group had higher pressures at work than the other two groups ( p <0.01), and tended to have higher pressures during sleep ( p <0.08). The sleep diastolic pressure of the Asymptomatic group was significantly lower than that of the women who had hot flashes on the study day ( p <0.01), but women who had a past history of hot flashes had slightly lower diastolic pressure ( p <0.01) than those in the other two groups overall. Heart rates of the Asymptomatic group, however, were significantly lower (4-6 b.p.m.; p <0.001) in each microenvironment and over the whole day than both groups who had hot flash experience. Conclusions : These data suggest first that there may be a relationship between the experience of hot flashes and accelerated heart rate, and second that women who do not experience hot flashes may have lower sleep blood pressures than women who do.