Hot flashes and night sweats increase women's risk of cardiovascular disease, according to new research.
The common and uncomfortable vasomotor symptoms could bring on a heart attack or stroke, say scientists.
It is estimated to affect more than seven in ten of those going through the change of life.
"Hot flashes are regarded as symptoms with implications for quality of life but not necessarily physical health," said lead author Dr. Rebecca Thurston, of the University of Pittsburgh.
"Accumulating research has called this long-held clinical wisdom into question and underscores that frequent or severe hot flushes may signal women who are at increased cardiovascular disease risk at midlife and beyond."
It has long been accepted they can affect mental health and quality of life. But concern is growing they can lead to heart and circulatory illnesses.
A previous review of data on 23,365 women by an Australian team found they increase the risk by 70 percent.
Cardiovascular disease is the leading cause of death in women - especially in midlife during the menopause transition.
Large epidemiologic and clinical studies using physiologic assessments have linked vasomotor symptoms to the world's biggest killer.
Specifically, women with more frequent hot flashes have poorer cardiovascular risk factor profiles.
These include high blood pressure, or hypertension, diabetes, high cholesterol and hardening of the arteries.
They have also been linked to increased likelihood of heart attacks and stroke as women age.
More recent research has also linked vasomotor symptoms to small vessel disease in the brain.
Thurston said potential underlying physiologic mechanisms may be behind the phenomenon.
The findings presented at a meeting of The North American Menopause Society in Atlanta open the door to a screening program.
Society director Dr. Stephanie Faubion said: "This presentation will introduce the latest thinking about how women with a high burden of vasomotor symptoms may particularly benefit from targeted cardiovascular reduction efforts as they age."
There are currently more than 3.5 million women in the UK living with heart disease. Sadly, 77 women die from a heart attack every day in the UK - around 28,000 women every year.
Globally, cardiovascular disease claims around 18 million lives annually - making it the number one cause of death in women as well as men.
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