Prospective early adulthood risk factors for vasomotor symptoms in the Coronary Artery Risk Development in Young Adults study : Menopause

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Prospective early adulthood risk factors for vasomotor symptoms in the Coronary Artery Risk Development in Young Adults study

Kim, Catherine MD, MPH1; Lane, Abbi PhD2; Vu, Thanh-Huyen T. MD, PhD3; Lewis, Cora B. MD4; Yin, Zhe MS5; Jiang, Hui PhD6; Auchus, Richard J. MD, PhD7; Schreiner, Pamela J. PhD8

Author Information

From the 1Departments of Medicine, Obstetrics and Gynecology, and Epidemiology, University of Michigan, Ann Arbor, MI

2Department of Kinesiology, University of Michigan, Ann Arbor, MI

3Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL

4Department of Preventive Medicine, University of Alabama, Birmingham, AL

5Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI

6Department of Biostatistics, University of Michigan, Ann Arbor, MI

7Department of Medicine, University of Michigan, Ann Arbor, MI

8Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.

Received September 18, 2023; revised and accepted November 21, 2023.

Funding/support: The Coronary Artery Risk Development in Young Adults (CARDIA) study is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I and HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). This work was supported by R56HL169167. This manuscript has been reviewed by CARDIA for scientific content.

Financial disclosures/conflicts of interest: Abbi Lane received past institutional funding from Nutrasource. Richard J. Auchus did contracted research for Neurocrine Biosciences/Diurnal LTD, Spruce Biosciences, Corcept Therapeutics, and Sparrow Pharmaceuticals, and was a consultant for Quest Diagnostics, Corcept Therapeutics, Xeris Pharmaceuticals, Crinetics Pharmaceuticals, Adrenas Therapeutics, PhaseBio Pharmaceuticals, Novo Nordisk, Neurocrine Biosciences/Diurnal LTD, Recordati Rare Diseases, H Lundbeck A/S, and Sparrow Pharmaceuticals. The other authors have nothing to disclose.

Address correspondence to: Catherine Kim, MD, MPH, Departments of Medicine, Obstetrics and Gynecology, and Epidemiology, University of Michigan, Rm 405E, Bldg 16, 2800 Plymouth Rd, Ann Arbor, MI 48109-5429. E-mail: [email protected]

Menopause 31(2):p 108-115, February 2024. | DOI: 10.1097/GME.0000000000002306

Objective 

Previous studies have assessed potential risk factors for vasomotor symptoms (VMS) beginning in midlife. We examined whether early adulthood risk factors predict VMS trajectories over time.

Methods 

We performed a secondary data analysis of the Coronary Artery Risk Development in Young Adults (CARDIA) study, a population-based cohort. We included women who answered questions about VMS at three or more examinations (n = 1,966). We examined whether risk factors at baseline (when participants were aged 18-30 y; average age, 25 y) and the year 15 (Y15) exam (at ages 33-45 y; average age, 40 y) were associated with VMS trajectories from Y15 through Y35. Logistic regression models were used to evaluate the associations with VMS trajectories.

Results 

We identified three trajectories of VMS presence: minimal (40%), increasing over time (27%), and persistent (33%). Baseline factors associated with persistent VMS over time included Black race, less than a high school education, depressive symptoms, migraines, cigarette use, and at Y15 hysterectomy. Baseline factors associated with increasing VMS over time included Black race and lower body mass index. Risk factors for bothersome VMS were similar and also included thyroid disease, although thyroid disease was not associated with persistence of VMS over time. Associations were similar among women who had not undergone hysterectomy and in Black and White women.

Conclusions 

Risk factors for VMS may be identified in early adulthood. Further examination of risk factors such as migraines and depressive symptoms in early adulthood may be helpful in identifying therapies for VMS.

© 2024 by The Menopause Society

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