Background. During the menopause transition, women are at an increased risk of developing hypertension, which is a key marker of cardiovascular disease (CVD). Although historically hot flashes have been considered a quality-of-life issue, emerging data provides a link between hot flashes and risk of CVD. Poor renal function is suggested to be one of the key physiological contributors to increased risk of hypertension and CVD among women with hot flashes. Thus, the aim of this study was to characterize the relationship between hot flashes and renal function in peri- and post-menopausal women using a retrospective chart review. We hypothesized that women with hot flashes would demonstrate reduced renal function compared to women without hot flashes.
Methods. We performed a chart review using serum creatinine and estimated glomerular filtration rate (eGFR) as proxies to assess renal function. Electronic health records for Mayo Clinic patients across multiple sites were abstracted for female patients who were diagnosed with peri- or post-menopause between 2016 and 2020, between 45 and 55 years of age, and had available creatinine laboratory test results. Data regarding demographics, anthropometrics, systemic blood pressure, menopausal stage, occurrence of hot flashes, and comorbidities were extracted from electronic health records. Differences between women with and without hot flashes were evaluated using two-tailed, independent samples t-tests. We completed a univariate analysis of variance testing the main effects of menopausal status (peri- or post-menopausal) and presence of hot flashes (yes or no). Given the potential modifying effects of menopause, analytical models were performed in duplicate with and without models separated by menopausal status (peri-and post-menopause).
Results. Data from 83 medical charts were assessed, including 57 women with hot flashes and 26 women without hot flashes. Without separating by menopausal status, there were no hot flash-related differences in age (51 ± 3 vs. 51 ± 3 years, P = 0.64) or body mass index (30 ± 7 vs. 33 ± 11, P = 0.19) between women with and without hot flashes. Additionally, there were no hot flash-related differences in metrics of blood pressure, including systolic (120 ± 13 vs. 125 ± 20, P = 0.19), diastolic (75 ± 11 vs. 77 ± 13, P = 0.54), and mean arterial pressure (90 ± 11 vs. 92 ± 14, P = 0.62). There were also no hot flash-related differences in indicators of renal function, including creatinine (0.8 ± 0.1 vs. 0.8 ± 0.2, P = 0.65) and eGFR (88 ± 11 vs. 85 ± 16, P = 0.36). The clinical characteristics of the perimenopausal versus postmenopausal women are summarized in Table 1 by hot flash status. There were no main effects of hot flash or menopausal status on creatinine (menopausal stage: p=0.810, hot flash status: p=0.659, interaction effect: p=0.983) or eGFR (menopausal stage: p=0.508, hot flash status: p=0.405, interaction effect: p=0.834).
Conclusions. In this retrospective chart review of peri- and post-menopausal women, there were no differences in systemic blood pressure or renal function between groups. Future investigations may include longitudinal markers of renal function and metrics describing frequency and severity of hot flashes.
