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Old 12-31-2009, 09:45 AM
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Default (1) Top 10 CME Articles 2009 ~ Nightsweats Post Menopausal Reduce Mortality

September 16, 2009 ? Night sweats in relatively healthy postmenopausal women are linked to a reduced risk for death during the following 20 years, independent of use of hormone therapy, according to the results of a prospective, population-based cohort study reported in the September issue of Menopause.

"Night sweats, reported by approximately half of postmenopausal women, are thought to reflect more severe hot flashes, although there is some evidence that they have a different etiology and may have more severe consequences related to impaired sleep. "The purpose of this study was to examine the associations of vasomotor symptoms with risk of all cause, cardiovascular disease (CVD), and coronary heart disease (CHD) mortality in community-dwelling older women, with a mean age of 69 years."

The study cohort consisted of 867 postmenopausal women who gave lifestyle and menopause-related history and who responded to a questionnaire, mailed in 19, on menopause and vasomotor symptoms. Follow-up for survival continued through July 2004 in 98% of the cohort. Average duration of follow-up was 11.5 years.

Hot flashes were reported by 73% of women, and 39% of these also reported night sweats. Of 405 deaths during follow-up, 194 were attributed to CVD and 71 to CHD. There was no apparent association between hot flashes alone and all-cause mortality. However, women who had night sweats as well as hot flashes had an almost 30% lower all-cause mortality risk vs women who did not have night sweats. This association was independent of body mass index (BMI), past or current use of estrogen or progestin, physical exercise, and smoking status.

After adjustment for past or current use of estrogen or progestin, there was a similar lower risk for CVD and CHD mortality in women with night sweats. Although these associations were independent of hormone use, adjustment for BMI, physical exercise, and smoking abolished their significance.

"Reported night sweats at menopause are associated with reduced risk of death over the following 20 years, independent of multiple risk factors including past or current use of postmenopausal estrogen therapy," the study authors write. "A similar association was observed for CVD mortality that was not independent of heart disease risk factors. Although these results are intriguing, they need to be confirmed in other large population-based studies."

Limitations of this study include history of vasomotor symptoms obtained many years after menopause for some women; possible recall bias; and inability to evaluate the effect of more recent, frequent symptoms or duration of symptoms. Because women in the study cohort are white and upper middle class, the results may not be generalizable to other populations.
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