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Brain blood flow and cardiovascular responses to hot flashes in postmenopausal women

Lucas, Rebekah A.I. PhD1,2; Ganio, Matthew S. PhD1,2,3; Pearson, James PhD1,2; Crandall, Craig G. PhD1,2

doi: 10.1097/gme.0b013e31826e45f0
Original Articles

Objective: This study tested two related hypotheses: (1) brain blood flow is reduced during postmenopausal hot flashes, and (2) the magnitude of this reduction in brain blood flow is greater during hot flashes when blood pressure is reduced.

Methods: Eleven healthy, normotensive postmenopausal women rested in a temperature-controlled laboratory (∼ 25°C) for approximately 120 minutes while waiting for a hot flash to occur. The onset of a hot flash was objectively identified by an abrupt increase in sternal sweat rate (capacitance hygrometry). Middle cerebral artery blood velocity (MCAv; transcranial Doppler) and mean arterial pressure (Finometer) were measured continuously. Each hot flash was divided into eight equal segments, and the segment with the largest reduction in MCAv and mean arterial pressure was identified for each hot flash.

Results: During experimental sessions, 25 hot flashes occurred (lasting a mean [SD] of 6.2 [2.8] min, with a mean frequency of 3 [1] hot flashes per participant). Seventy-six percent of hot flashes were accompanied by a clear reduction (>5%) in brain blood flow. For all hot flashes, the mean maximal decrease in MCAv was 12% (9%) (7 [6] cm s−1). This value did not correlate with corresponding changes in mean arterial pressure (R = 0.36).

Conclusions: These findings demonstrate that hot flashes are often accompanied by clear reductions in brain blood flow that do not correspond with short-term reductions in mean arterial blood pressure.

From the 1Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX; 2Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX; and 3Depatment of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR.

Received May 8, 2012; revised and accepted July 23, 2012.

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding/support: This study was supported by National Institutes of Health grant AG030189.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Craig G. Crandall, PhD, University of Texas Southwestern Medical Center, 7232 Greenville Avenue, Dallas, TX 75231. E-mail: CraigCrandall@TexasHealth.org

© 2013 by The North American Menopause Society.