Letter to the editor Vasomotor menopausal symptoms and risk of stroke among mid-aged women Dear editor, Although vasomotor menopausal symptoms (VMS) [i.e. hot flushes (HF) and night sweats (NS)] have been related to Correspondence: G.-C. Herber-Gast*, School of Population Health, University of Queensland, Herston Road, Brisbane, Qld 4006, Australia. E-mail: [email protected] Conflict of interest: None declared. Funding: The ALSWH is funded by the Australian Commonwealth Department of Health. GCHG is supported by an Australian National Health and Medical Research Council Centre of Research Excellence grant (APP1000986). DOI: 10.1111/ijs.12415
© 2015 World Stroke Organization
coronary heart disease, the relationship with stroke risk is less clear and underresearched. The Women’s Health Initiative (WHI) Observational Study found that early-onset, but not late-onset, VMS were associated with lower risk of stroke (1). Data, however, were only available from two time-points and HF and NS were not delineated. We investigated whether HF and NS were associated with incident stroke. Self-reported data (collected in 1996 and every three-years from 1998 to 2010) were from 12 577 participants of the Australian Longitudinal Study on Women’s Health born in 1946– 51. Neither HF nor NS were associated with stroke (n = 249); adjusted odds ratios (95% CIs) were 1·09 (0·82–1·45) and 1·20 (0·90–1·62) respectively. Sample and data differences may explain contrasting findings of the WHI Study. Whereas
our study included premenopausal midage (45 to 50 years at entry) Australian women, the WHI study studied a multiethnic cohort of older postmenopausal women (aged 50–79 years at entry), and used a priori grouping rather than our data-driven approach to define VMS. Our results suggest that in mid-aged women VMS do not appear to be associated with stroke incidence. S. Conrad and G.-C. Herber-Gast* School of Population Health, University of Queensland, Brisbane, Qld, Australia
Reference 1 Szmuilowicz ED, Manson JE, Rossouw JE et al. Vasomotor symptoms and cardiovascular events in postmenopausal women. Menopause 2011; 18:603–10.
Vol 10, February 2015, E13
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© 2015 World Stroke Organization
coronary heart disease, the relationship with stroke risk is less clear and underresearched. The Women’s Health Initiative (WHI) Observational Study found that early-onset, but not late-onset, VMS were associated with lower risk of stroke (1). Data, however, were only available from two time-points and HF and NS were not delineated. We investigated whether HF and NS were associated with incident stroke. Self-reported data (collected in 1996 and every three-years from 1998 to 2010) were from 12 577 participants of the Australian Longitudinal Study on Women’s Health born in 1946– 51. Neither HF nor NS were associated with stroke (n = 249); adjusted odds ratios (95% CIs) were 1·09 (0·82–1·45) and 1·20 (0·90–1·62) respectively. Sample and data differences may explain contrasting findings of the WHI Study. Whereas
our study included premenopausal midage (45 to 50 years at entry) Australian women, the WHI study studied a multiethnic cohort of older postmenopausal women (aged 50–79 years at entry), and used a priori grouping rather than our data-driven approach to define VMS. Our results suggest that in mid-aged women VMS do not appear to be associated with stroke incidence. S. Conrad and G.-C. Herber-Gast* School of Population Health, University of Queensland, Brisbane, Qld, Australia
Reference 1 Szmuilowicz ED, Manson JE, Rossouw JE et al. Vasomotor symptoms and cardiovascular events in postmenopausal women. Menopause 2011; 18:603–10.
Vol 10, February 2015, E13
E13
