Skip to main content
SpringerLink
Log in

Herzfrequenzvariabilität in der Postmenopause

Heart rate variability in postmenopause

  • Menopause und Frauengesundheit
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Autonomes Nervensystem und Herzfrequenzvariabilität

Sowohl eine Dysregulation des autonomen Nervensystems (ANS) als auch die Menopause sind mit einem erhöhten kardiovaskulären Risiko verbunden. Das kardiale ANS kann anhand der Herzfrequenzvariabilität (HRV) beurteilt und in Frequenzspektren aufgespalten werden, die sich dem Parasympathikus- und/oder Sympathikuseinfluss zuordnen lassen.

Einfluss der endokrinen Lebensphasen

Bereits während des Menstruationszyklus zeigt sich eine zyklusabhängige Fluktuation der HRV. Mit dem menopausalen Östrogenabfall ist ein Anstieg des Sympathikotonus mit HRV-Reduktion verbunden, was mit einem erhöhten kardiovaskulären Risiko einhergeht. Das mit menopausalen Hitzewallungen verbundene erhöhte kardiovaskuläre Erkrankungsrisiko ist möglicherweise ebenso auf eine Sympathikusaktivierung zurückzuführen.

Therapie

Eine Hormonersatztherapie vermag eventuell eine Wiederherstellung der autonomen Balance herbeizuführen.

Abstract

Autonomic nervous system and heart rate variability

Both dysregulation of the autonomic nervous system (ANS) and menopause are associated with a higher cardiovascular risk. The cardiac ANS can be assessed by means of heart rate variability (HRV), as the variation between consecutive RR intervals is influenced by parasympathetic and sympathetic mediators.

Effects of menstrual cycle phases

During the menstrual cycle, a cycle-dependent HRV fluctuation has been found, and a HRV reduction occurs upon estrogen withdrawal after menopause. Postmenopausal HRV reduction is associated with a higher sympathetic tone and is accompanied by a higher cardiovascular risk. Recent findings suggest a role of the sympathetic drive in the genesis of menopausal hot flashes, as an abrupt reduction of the parasympathetic tone with a predominance of the sympathetic tone occurs during a hot flash.

Therapy

Hormone replacement therapy may restore the autonomic balance. However, type and combination of hormones may be crucial.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Bai X, Li J, Zhou L et al (2009) Influence of the menstrual cycle on nonlinear properties of heart rate variability in young women. Am J Physiol Heart Circ Physiol 297:H765–H774

    Article  PubMed  CAS  Google Scholar 

  2. Berntson GG, Bigger JT Jr, Eckberg DL et al (1997) Heart rate variability: origins, methods, and interpretive caveats. Psychophysiology 34:623–648

    Article  PubMed  CAS  Google Scholar 

  3. Davy KP, Desouza CA, Jones PP et al (1998) Elevated heart rate variability in physically active young and older adult women. Clin Sci 94:579–584

    PubMed  CAS  Google Scholar 

  4. Farag NH, Nelesen RA, Parry BL et al (2002) Autonomic and cardiovascular function in postmenopausal women: the effects of estrogen versus combination therapy. Am J Obstet Gynecol 186:954–961

    Article  PubMed  CAS  Google Scholar 

  5. Freedman RR, Kruger ML, Wasson SL (2011) Heart rate variability in menopausal hot flashes during sleep. Menopause 18:897–900

    Article  PubMed  Google Scholar 

  6. Gambacciani M, Pepe A (2009) Vasomotor symptoms and cardiovascular risk. Climacteric 12(Suppl 1):32–35

    Article  PubMed  Google Scholar 

  7. Gokce M, Karahan B, Yilmaz R et al (2005) Long term effects of hormone replacement therapy on heart rate variability, QT interval, QT dispersion and frequencies of arrhythmia. Int J Cardiol 99:373–379

    Article  PubMed  Google Scholar 

  8. Hulley S, Grady D, Bush T et al (1998) Randomized trial of estrogen plus progestin for secondary prevention of coronary heart disease in postmenopausal women. Heart and Estrogen/progestin Replacement Study (HERS) research group. JAMA 280:605–613

    Article  PubMed  CAS  Google Scholar 

  9. Kannel WB, Hjortland MC, McNamara PM et al (1976) Menopause and risk of cardiovascular disease: the Framingham study. Ann Intern Med 85:447–452

    Article  PubMed  CAS  Google Scholar 

  10. Lantto H, Haapalahti P, Tuomikoski P et al (2012) Vasomotor hot flashes and heart rate variability: a placebo-controlled trial of postmenopausal hormone therapy. Menopause 19:82–88

    Article  PubMed  Google Scholar 

  11. Lee JO, Kang SG, Kim SH et al (2011) The relationship between menopausal symptoms and heart rate variability in middle aged women. Korean J Fam Med 32:299–305

    Article  PubMed  Google Scholar 

  12. Liao D, Cai J, Rosamond WD et al (1997) Cardiac autonomic function and incident coronary heart disease: a population-based case-cohort study. The ARIC study. Atherosclerosis risk in communities study. Am J Epidemiol 145:696–706

    Article  PubMed  CAS  Google Scholar 

  13. Liu CC, Kuo TB, Yang CC (2003) Effects of estrogen on gender-related autonomic differences in humans. Am J Physiol Heart Circ Physiol 285:H2188–H2193

    PubMed  CAS  Google Scholar 

  14. Mendelsohn ME, Karas RH (2005) Molecular and cellular basis of cardiovascular gender differences. Science 308:1583–1587

    Article  PubMed  CAS  Google Scholar 

  15. Mendelsohn ME, Karas RH (1999) The protective effects of estrogen on the cardiovascular system. N Engl J Med 340:1801–1811

    Google Scholar 

  16. Mercuro G, Podda A, Pitzalis L et al (2000) Evidence of a role of endogenous estrogen in the modulation of autonomic nervous system. Am J Cardiol 85:787–789, A789

    Article  PubMed  CAS  Google Scholar 

  17. Moodithaya SS, Avadhany ST (2009) Comparison of cardiac autonomic activity between pre and post menopausal women using heart rate variability. Indian J Physiol Pharmacol 53:227–234

    PubMed  Google Scholar 

  18. Neves VF, Silva de Sá MF, Gallo L Jr et al (2007) Autonomic modulation of heart rate of young and postmenopausal women undergoing estrogen therapy. Braz J Med Biol Res 40:491–499

    Article  PubMed  CAS  Google Scholar 

  19. Niskanen L, Laitinen T, Tuppurainen M et al (2002) Does postmenopausal hormone replacement therapy affect cardiac autonomic regulation in osteoporotic women? Menopause 9:52–57

    Article  PubMed  Google Scholar 

  20. Ribeiro TF, Azevedo GD, Crescencio JC et al (2001) Heart rate variability under resting conditions in postmenopausal and young women. Braz J Med Biol Res 34:871–877

    Article  PubMed  CAS  Google Scholar 

  21. Rosano GM, Chierchia SL, Leonardo F et al (1996) Cardioprotective effects of ovarian hormones. Eur Heart J 17(Suppl D):15–19

    Article  Google Scholar 

  22. Rosano GM, Leonardo F, Sarrel PM et al (1996) Cyclical variation in paroxysmal supraventricular tachycardia in women. Lancet 347:786–788

    Article  PubMed  CAS  Google Scholar 

  23. Saeki Y, Atogami F, Takahashi K et al (1997) Reflex control of autonomic function induced by posture change during the menstrual cycle. J Auton Nerv Syst 66:69–74

    Google Scholar 

  24. Sato N, Miyake S, Akatsu J et al (1995) Power spectral analysis of heart rate variability in healthy young women during the normal menstrual cycle. Psychosom Med 57:331–335

    PubMed  CAS  Google Scholar 

  25. Stauss HM (2003) Heart rate variability. Am J Physiol Regul Integr Comp Physiol 285:R927–R931

    PubMed  CAS  Google Scholar 

  26. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology (1996) Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J 17:354–381

    Google Scholar 

  27. Thurston RC, Christie IC, Matthews KA (2012) Hot flashes and cardiac vagal control during women’s daily lives. Menopause 19:406–412

    Article  PubMed  Google Scholar 

  28. Thurston RC, Christie IC, Matthews KA (2010) Hot flashes and cardiac vagal control: a link to cardiovascular risk? Menopause 17:456–461

    PubMed  Google Scholar 

  29. Tsuji H, Larson MG, Venditti FJ Jr et al (1996) Impact of reduced heart rate variability on risk for cardiac events. The Framingham heart study. Circulation 94:2850–2855

    Article  PubMed  CAS  Google Scholar 

  30. Weissman A, Lowenstein L, Tal J et al (2009) Modulation of heart rate variability by estrogen in young women undergoing induction of ovulation. Eur J Appl Physiol 105:381–386

    Article  PubMed  CAS  Google Scholar 

  31. Yildirir A, Kabakci G, Akgul E et al (2002) Effects of menstrual cycle on cardiac autonomic innervation as assessed by heart rate variability. Ann Noninvasive Electrocardiol 7:60–63

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Die korrespondierende Autorin gibt für sich und ihre Koautoren an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Abteilung für Gynäkologische Endokrinologie und Reproduktionsmedizin, Frauenklinik, Inselspital Bern, Effingerstr. 102, 3010, Bern, Schweiz

    G. Capaldo & P. Stute

  2. Kardiovaskuläre Prävention und Rehabilitation, Universitätsklinik für Kardiologie, Inselspital Bern, Bern, Schweiz

    M. Wilhelm

Authors
  1. G. Capaldo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Wilhelm
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Stute
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Capaldo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Capaldo, G., Wilhelm, M. & Stute, P. Herzfrequenzvariabilität in der Postmenopause. Gynäkologische Endokrinologie 11, 140–143 (2013). https://doi.org/10.1007/s10304-013-0553-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10304-013-0553-7

Schlüsselwörter

Keywords

Search

Navigation