Association of Race/Ethnicity to Cardiovascular Symptoms in Midlife Women: A Cluster Analysis

Background. Although racial/ethnic differences in hormone levels during menopausal transition tend not to be prominent, the hormone differences could actually affect the development of racial/ethnic differences in cardiovascular diseases (CVDs). The purpose of this study was to determine the association of race/ethnicity to cardiovascular symptoms experienced during menopausal transition through a cluster analysis, and determine racial/ethnic differences in the clusters to identify risk groups of cardiovascular diseases among midlife women.

Methods. This was a secondary analysis of the data from 966 midlife women in two larger studies. This analysis used only the data from the questions on background characteristics, perceived health, and menopausal status and the Cardiovascular Symptom Index for Midlife Women. The data were analyzed using inferential statistics including hierarchical cluster analysis and multinominal logistic analysis.

Results.A three-cluster solution was chosen: Cluster 1 (high vasomotor symptoms and low cardiorespiratory symptoms), Cluster 2 (low vasomotor symptoms, high cardiorespiratory symptoms, and high discomfort/pain), and Cluster 3 (high discomfort/pain and high indigestion symptoms). Among the three clusters, Cluster 1 may be the unique group at risk of CVDs due to their menopausal transition. There existed significant racial/ethnic differences in cardiovascular symptoms in all three Clusters (p<.01). Asian Americans reported significantly lower numbers and severity scores of the symptoms than other racial/ethnic groups (p<.01). Therefore, Asian Americans may not be the risk group to target in preventive interventions.

Conclusions. Understanding racial/ethnic variances in cardiovascular symptoms experienced during menopausal transition is essential to provide more risk-based screening to promote better cardiovascular outcomes.