Our overall research goal is to improve knowledge related to cardiovascular disease (CVD) risk in women so they can live longer, healthier lives.
Menopause and CVD risk
Cardiovascular disease (CVD) risk increases to a greater degree during the transition to menopause than at other times in a woman’s life. Blood pressure, obesity, and cholesterol have all been shown to increase in midlife women from the pre- to the postmenopausal years. The increase in CVD risk factors leads to greater risk of CVD-related events such as heart attack and stroke. Interestingly, there is a growing awareness that conventional CVD risk factors such as blood pressure and cholesterol may underestimate a woman’s risk for cardiovascular disease. Therefore, our lab is interested in evaluating non-traditional risk factors for CVD such as blood vessel health in midlife women.
Menopausal hot flashes have traditionally been considered a bothersome quality of life issue for women. However, hot flashes are now recognized to be a potential marker of CVD risk as increased frequency and severity of hot flashes have been positively associated with CVD risk factors, subclinical CVD markers (see figure below), clinical cardiovascular events, and CVD mortality. Recent data, including data from our lab, has shown that a higher frequency of hot flashes (e.g. number per day) was associated with lower vascular endothelial function, a subclinical CVD risk factor, in women undergoing the menopausal transition (perimenopausal women).
Major findings from our research in this area include: (*indicates undergraduate student author):
Higher levels of cardiorespiratory fitness are associated with better quality of life in midlife women. (Publication: Flesaker MQ*, Serviente C, Troy LM, Witkowski S. The role of cardiorespiratory fitness on quality of life in midlife women. Menopause. 2021 Jan 11;28(4):431-438)
Peri- and postmenopausal women with high cardiorespiratory fitness have a less atherogenic lipid profile than lower active women. (Publication: Serviente C, Chalvin M*, Witkowski S. The influence of menopause and cardiorespiratory fitness on lipoprotein particles in midlife women. Appl Physiol Nutr Metab. 2022 Apr;47(4):447-457)
The relationship between physical activity and hot flashes differs whether the outcomes are subjectively or objectively measured. (Publication: Witkowski S, White Q*, Shreyer S, Brown DE, Sievert LL. The influence of habitual physical activity and sedentary behavior on objective and subjective hot flashes at midlife. Menopause. 2024 May 1;31(5):381-389)
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- Increasing sitting time by 1 hour was associated with a 7% increase in the rate of objectively measured but not subjectively reported hot flashes during sleep
- Replacing 1 hour of sitting with 1 hour of vigorous activity was associated with a 100% increase in subjectively reported but not objectively measured waking hot flashes.
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Acute changes in physical activity and acute moderate exercise change hot flash experience.
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- Objectively measured increases in physical activity occur in the 10 minutes proceeding a HF 31% of the time, indicating that physical activity may trigger hot flashes. (Publication: Witkowski S, White Q*, Shreyer S, Garcia RL, Brown DE, Sievert LL. Acute increases in physical activity and temperature are associated with hot flash experience in midlife women. Menopause. 2024 Jul 1;31(7):600-607)
- The rate of objectively-measured HF was lower in the 24-hr following moderate-intensity acute exercise compared with a no-exercise condition in perimenopausal women with HFs. (Presentation: Witkowski, S, Murphy L, Buszkiewicz, S*, Sievert, LL. The effect of acute exercise on hot flash experience in healthy perimenopausal people. Poster Presentation. North American Menopause Society Annual Meeting, October 2022).
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For perimenopausal women, engagement in higher amounts of moderate to vigorous physical activity ameliorates the relationship between HFs and FMD: (Publication: Witkowski, Tha Ra Wun T*, Brunzelle J*, Buszkiewicz S*, Murphy L, Garcia R, and Sievert LL. Higher amounts of habitual physical activity changes the relationship between hot flashes and subclinical CVD risk. Physiol Rep. 2025 Feb;13(3):e70248.)
Greater amounts of objectively-measured moderate to vigorous physical activity is associated with lower arterial stiffness in perimenopausal women (Conference Presentation: Tha Ra Wun T*, Brunzelle J*, Murphy L, Garcia R, Sievert LL, Witkowski S. Objectively measured hot flashes and moderate-vigorous activity predict arterial stiffness in healthy perimenopausal women. American Physiology Summit, April 4-7, 2024, Long Beach, CA).
These findings are significant because:
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- They indicate that using both objective measures and subjective reports can improve our understanding of the hot flash experience, the relationship between hot flashes, physical activity, and subclinical CVD risk.
- Our findings also improve knowledge on the health of perimenopausal women, where the association between hot flashes and CVD appears to be strongest and where there is little data because they have been underrepresented in the research.
- Finally, these results are significant because they can improve recommendations for midlife women undergoing the transition to menopause.
Our current study is designed to understand the effects of vasomotor symptoms (VMS, e.g. hot flashes and night sweats) on sleep and whether physical activity influences the effects.
We are recruiting women who experience VMS and are aged 43-54!
If you are interested in finding out more about this study or our research on menopause,