Evidence map›Paper›PMID 27676638›Full record

ArticleMenopause (New York, N.Y.)2017

Menopausal symptoms and cardiovascular disease mortality in the Women's Ischemia Syndrome Evaluation (WISE).

Rebecca C Thurston, B Delia Johnson, Chrisandra L Shufelt, Glenn D Braunstein, Sarah L Berga, Frank Z Stanczyk, Carl J Pepine, Vera Bittner, Steven E Reis, Diane V Thompson and 3 more

Open access · greenAbstract readMulticenter Study
In one paragraph

Article in Menopause (New York, N.Y.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed
8.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 74 citations in OpenAlex.

  1. Trial
  2. Randomized Placebo Controlled Trial of Low-Dose Tamoxifen to Prevent Local and Contralateral Recurrence in Breast Intraepithelial Neoplasia.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2019
    Trial
  3. Trial
  4. Review
  5. Vasomotor symptoms of menopause, sympathetic activity, and blood pressure in postmenopausal females.American journal of physiology. Heart and circulatory physiology · 2025
    Article
  6. Article
  7. Lifestyle medicine pillars for women's heart health.American journal of preventive cardiology · 2025
    Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Vasomotor symptoms and cardiovascular health: findings from the SWAN and the MsHeart/MsBrain studies.Climacteric : the journal of the International Menopause Society · 2024
    Review
  13. Vasomotor symptoms and their links to cardiovascular disease risk.Current opinion in endocrine and metabolic research · 2023
    Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Menopausal Vasomotor Symptoms and Risk of Incident Cardiovascular Disease Events in SWAN.Journal of the American Heart Association · 2021 · on this map
    Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 1 country.

Rebecca C Thurston1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 2Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 3Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA 4Section of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC 5Department of Obstetrics and Gynecology, Keck School of Medicine of University of Southern California, Los Angeles, CA 6Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL 7Division of Cardiovascular Disease, Department of Medicine, University of Alabama Birmingham, AL 8Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 9Division of Cardiology, Department of Medicine, Allegheny General Hospital, Pittsburgh, PA 10Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
B Delia Johnson
Chrisandra L Shufelt
Glenn D Braunstein
Sarah L Berga
Frank Z Stanczyk
Carl J Pepine
Vera Bittner
Steven E Reis
Diane V Thompson
Sheryl F Kelsey
George Sopko
C Noel Bairey Merz
University of Pittsburgh · USCedars-Sinai Smidt Heart Institute · USAllegheny General Hospital · USNational Heart Lung and Blood Institute · USUniversity of Alabama at Birmingham · USUniversity of Florida · USUniversity of Southern California · USWake Forest University · US

Funding

Women's Ischemia Syndrome EvaluationU01HL064829 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KELSEY, SHERYL F. · 2001 to 2005
$3.9M
Renin Angiotensin for Coronary Microvascular DysfunctionU01HL064924 · NHLBI · UNIVERSITY OF FLORIDA · PI PEPINE, CARL J · 2001 to 2005
$2.0M
Prediction of Cardiomyopathy in Type I Diabetes by MRSR01HL073412 · NHLBI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI POHOST, GERALD MICHAEL · 2002 to 2007
$2.0M
Interdisciplinary Mentoring and Research in Womens Cardiovascular HealthK24HL123565 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI THURSTON, REBECCA C · 2014 to 2023
$1.0M
Functional MRI of the pharyngeal airwayR01HL068162 · NHLBI · UNIVERSITY OF ARIZONA · PI FREGOSI, RALPH FRANK · 2003 to 2005
$899k
ISCHEMIC HEART DISEASE IN WOMEN--CLINICAL CENTERN01HV068163 · HV · UNIVERSITY OF FLORIDA · PI PEPINE, CARL J · 1996 to 2001
$386k
ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CENTERN01HV068161 · HV · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI ROGERS, WILLIAM J · 1996 to 2000
$245k
EVAL OF ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CTRN01HV068164 · HV · ALLEGHENY-SINGER RESEARCH INSTITUTE · PI REICHEK, NATHANIEL · 1996 to 2001
–
EVAL OF ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CTR-N01HV68162-268068162N01HV068162 · HV · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 1996 to 2005
–
NHLBI NIH HHS K24 HL123565NHLBI NIH HHS N01 HV068161NHLBI NIH HHS N01 HV068162NHLBI NIH HHS N01 HV068163NHLBI NIH HHS N01 HV068164NHLBI NIH HHS R01 HL073412NHLBI NIH HHS U01 HL064829NHLBI NIH HHS U01 HL064924
6 · The paper itself

Abstract

objectiveStudies have linked vasomotor symptoms (VMS) to markers of cardiovascular disease (CVD) risk, yet few have considered clinical cardiovascular events. Data suggest that associations may depend upon the age that symptoms occur. We examined associations between VMS and cardiovascular events and endothelial function, considering age of symptom onset.

methodsThe Women's Ischemia Syndrome Evaluation enrolled women referred for coronary angiography for suspected myocardial ischemia. A total of 254 women aged more than 50 years, postmenopausal, with both ovaries, not taking hormone therapy underwent a baseline evaluation, were followed annually (median = 6.0 y), and the National Death Index was searched to ascertain CVD mortality (median = 9.3 y). A subset of participants underwent brachial artery ultrasound for flow-mediated dilation (FMD). Receiver-operating curve analysis was used to determine vasomotor symptom groups (symptoms beginning < age 42 [early onset], beginning ≥42 [later onset], never) which were examined in relation to cardiovascular events and FMD in Cox proportional hazard and linear regression models.

resultsWomen reporting early onset VMS (HR = 3.35, 95% CI = 1.23-7.86, P = 0.005) and women who never had VMS (HR = 2.17, 95% CI = 1.02-4.62, P = 0.05) had higher CVD mortality than women with later onset symptoms (multivariable models). Women with early onset VMS had lower FMD than women with later onset symptoms (b = -4.31, SE = 2.10, P = 0.04, multivariable).

conclusionsWomen with signs and symptoms of ischemia who had VMS beginning early in midlife had higher CVD mortality and reduced endothelial function relative to women with later onset symptoms. Future research should evaluate the vascular phenotype of women with early midlife VMS.

Indexed as

PostmenopauseAgedAge FactorsCardiovascular DiseasesCause of DeathCoronary AngiographyFemaleHumansMiddle AgedMyocardial IschemiaProspective StudiesRisk FactorsSyndrome

Identifiers

PMID27676638
PMCPMC5266637
OpenAlexW2464018553

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.