104 Linking vasomotor symptom severity to physiological health in peri/menopausal women: The role of hormone therapy in menopause treatment

Objectives/Goals: In peri- and postmenopausal women, to determine 1) whether vasomotor symptoms (VMS) reflect underlying vascular and skeletal muscle dysfunction as well as cardiorespiratory fitness (CRF) and 2) to assess the impact of hormone replacement therapy (HRT) on VMS, vascular and muscular function, and CRF. Methods/Study Population: Peri- and postmenopausal women with 1) no/mild, 2) moderate, or 3) severe VMS will be recruited. Muscle and vascular function as well as CRF will be assessed at baseline and after 3 months in women who initiate VMS-specific therapy (HRT vs. SSRIs). Muscle function will be assessed as quadriceps strength (MVC), size (ultrasound), and contraction kinetics (nerve stimulation). Vascular function will be assessed as brachial flow-mediated dilation and carotid artery measures including intima-media thickness. CRF will be assessed during a graded cardiopulmonary exercise test. VMS will be tracked via ambulatory skin temperature, blood pressure, and heart rate (via wearable device(s)) and patient symptomology diaries completed during the 1st, 6th, and 12th week after treatment initiation. Results/Anticipated Results: We anticipate that 1) increasing VMS severity will be associated smaller muscle size and impaired function, worse vascular function, and lower CRF after correcting for independent variables (e.g., age, time in peri/menopause, BMI, and ethnicity); 2) HRT will result in great improvements in muscle and vascular function and CRF, as well as greater alleviation of VMS, compared to SSRIs initiation. Discussion/Significance of Impact: This research will elucidate potential physiological system correlates and dysfunction that occur during VMS events. This insight into the physiological underpinnings of VMS will inform optimal management strategies that can improve quality of life and cardiovascular health in menopausal women.