Ideal Cardiovascular Health Metrics and Risk of Incident Early-Onset Vasomotor Symptoms Among Premenopausal Women

Hye Rin Choi, Yoosoo Chang, Yejin Kim, Yoosun Cho, Jeonggyu Kang, Min Jung Kwon, Ria Kwon, Ga Young Lim, Kye Hyun Kim, Hoon Kim, Yun Soo Hong, Jihwan Park, Di Zhao, Juhee Cho, Eliseo Guallar, Hyun Young Park, Seungho Ryu

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Context: The relationship of ideal cardiovascular health (CVH) behaviors with preventing early-onset vasomotor symptoms (VMSs) is unknown. Objective: We investigated the association between CVH metrics and the development of early-onset VMSs in premenopausal women. Methods: This cohort study included 2541 premenopausal women aged 42 to 52 years without VMSs at baseline. CVH metrics were defined according to the American Heart Association Life Simple 7 metrics. Owing to limited availability of dietary information, CVH metrics were scored from 0 (unhealthy) to 6 (healthy) and classified into 3 groups: Poor (0-2), intermediate (3-4), and ideal (5-6) CVH. VMSs, including hot flashes and night sweats, were assessed using the Menopause-Specific Quality of Life questionnaire. Moderate/severe VMSs was defined as a score of 3 or more points (range, 0 to 6; 6 being most bothersome). Results: During a median follow-up of 4.5 years, 1241 women developed VMSs before menopause. After adjustment for age, parity, education level, and alcohol consumption, the hazard ratio (HR) (95% CI) for developing early-onset VMSs comparing poor CVH group to the ideal group was 1.41 (1.07-1.86). CVH scores were also inversely associated with moderate/severe VMSs in a dose-response manner (P for trend=.004); specifically, multivariable-adjusted HRs comparing intermediate and poor CVH groups to the ideal group were 1.20 (95% CI, 1.02-1.43) and 1.57 (95% CI, 1.08-2.29), respectively. Conclusion: Unfavorable CVH metrics were significantly associated with an increased risk of early-onset VMSs and its more severe forms among premenopausal women.

Original languageEnglish
Pages (from-to)2666-2673
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Issue number9
StatePublished - 1 Sep 2022


  • cardiovascular health metrics
  • menopause
  • vasomotor symptoms


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