Background Increased prevalence of mood symptoms during menopause - PDF document

Background  Increased prevalence of mood symptoms during menopause Increased Anxiety and Depressive Symptoms Are  Anxiety and depression associated with alterations in cardiac Associated with Abnormal Resting Cardiac autonomic function in non-menopausal population Autonomic Function in Peri- and Postmenopausal  Cardiac autonomic function alterations associated with Women with Hot Flashes adverse cardiovascular outcome and chronic diseases (diabetes, hypertension) Polly Fu, MD Department of Medicine University of California, San Francisco 10/4/2018 2 Anxiety, Depression, and Autonomic Function Background and Aim Methods Menopausal Treatment Using Relaxation Exercise (MaTURE) Trial  Increased risk for accumulation of cardiovascular risk factors  Parellel-group, single-blinded, randomized trial of slow-paced during menopause with hot flashes linked to subclinical respiration for treatment of hot flashes cardiovascular disease  Peri- and postmenopausal women, age 40-59 years old, with at least four hot flashes reported per day  To examine whether anxiety and depressive symptoms are  Recruited from San Francisco Bay Area from Jan 2012 to associated with an adverse cardiac autonomic profile among Dec 2014 midlife women with hot flashes 3 Anxiety, Depression, and Autonomic Function 4 Anxiety, Depression, and Autonomic Function 1 | [footer text here]

Methods Methods Menopausal Treatment Using Relaxation Exercise (MaTURE) Trial Menopausal Treatment Using Relaxation Exercise (MaTURE) Trial  Anxiety and depressive symptoms assessed as continuous  Resting cardiac autonomic function assessed via impedence scores cardiography and ECG - Spielberger State Trait Anxiety Inventory - Respiratory sinus arrhythmia (RSA): Parasympathetic activity - Hospital Anxiety and Depression Scale - Pre-ejection period (PEP): Sympathetic activity - Beck Depression Inventory-II 5 Anxiety, Depression, and Autonomic Function 6 Anxiety, Depression, and Autonomic Function Methods Results Menopausal Treatment Using Relaxation Exercise (MaTURE) Trial  To determine associations between anxiety, depression, and  Among 121 participants (mean age 53 years old) cardiac autonomic markers - Mean of 8 hot flashes per day - Multivariable repeated measures linear regression models - No significant differences in anxiety and depressive symptoms between paced respiration and music control groups - Adjusted for age and body mass index - Resting cardiac autonomic markers were similar at baseline and - Corrected for multiple comparisons with Benjamini-Hochberg at 12 weeks with no significant between-group differences procedure 7 Anxiety, Depression, and Autonomic Function 8 Anxiety, Depression, and Autonomic Function 2 | [footer text here]

Results Results Anxiety, Depression, and RSA (Marker of Parasympathetic Activity) Anxiety, Depression, and PEP (Marker of Sympathetic Activity) Respiratory Sinus Arrhythmia Pre-Ejection Period β (SE) P-value β (SE) P-value STAI – State Anxiety -0.16 (0.01) STAI – State Anxiety -0.24 (0.09) 0.06 0.02 STAI – Trait Anxiety -0.03 (0.01) STAI – Trait Anxiety -0.11 (0.10) 0.24 0.006 HADS Anxiety -0.06 (0.02) HADS Anxiety -0.31 (0.27) 0.25 0.02 Beck Depression Inventory -0.03 (0.01) Beck Depression Inventory -0.09 (0.17) 0.60 0.04 HADS Depression -0.07 (0.03) HADS Depression -0.40 (0.36) 0.26 0.03 STAI – Spielberger State Trait Anxiety Inventory; HADS – Hospital Anxiety and Depression Scale STAI – Spielberger State Trait Anxiety Inventory; HADS – Hospital Anxiety and Depression Scale 9 Anxiety, Depression, and Autonomic Function 10 Anxiety, Depression, and Autonomic Function Summary Summary Among peri- and postmenopausal women with hot flashes,  Our findings are consistent with prior studies showing lower resting parasympathetic activity in patients with clinical  Greater self-reported anxiety and depression were associated anxiety disorders and major depressive disorder with lower cardiac vagal tone  Greater self-reported state anxiety was associated with higher resting sympathetic nervous system activation  From cardiovascular risk standpoint, lower RSA associated with hypertension, hyperglycemia, and obesity. Lower RSA was also a strong predictor of sudden cardiac death after myocardial infarction 11 Anxiety, Depression, and Autonomic Function 12 Anxiety, Depression, and Autonomic Function 3 | [footer text here]

Conclusions Acknowledgements  Midlife women with increased anxiety and depressive  Alison J. Huang, MAS, MPhil symptoms may have an unfavorable cardiac autonomic  Caroly J. Gibson, PhD, MPH profile with potential implication for their overall  Wendy Berry Mendes, PhD cardiovascular risk  Michael Schembri, BS MaTURE trial was funded by National Center for Complementary and Integrative Health grant #5R01AT005491 13 Anxiety, Depression, and Autonomic Function 14 Anxiety, Depression, and Autonomic Function 4 | [footer text here]