Some midlife women tend to have more severe cardiorespiratory symptoms than others during their menopausal transition as they go through changes in aortic pulse-wave velocity, distinct lipid/lipoprotein profiles, hormone levels, and blood pressure. These symptoms may mean high risks of cardiorespiratory diseases. However, little is currently known about the characteristics of these women with high (more severe) cardiorespiratory symptoms during the menopausal transition. A cluster analysis is known to help identify groups in a dataset where individuals within a specific group have similar characteristics. In other words, a cluster analysis is helpful in identifying risk groups of midlife women in terms of their cardiorespiratory symptoms. The purpose of this study was to determine the characteristics of midlife women with high cardiorespiratory symptoms using a cluster analysis.

This secondary analysis was conducted with the data from two large survey studies among 966 midlife women. The parent studies were Internet-based survey studies that aimed to explore racial/ethnic differences in the symptoms that were experienced during the menopausal transition and the characteristics linked to the symptoms (e.g., lifestyle factors such as physical activity, nutrition, smoking, etc.).  Cardiorespiratory symptoms were measured using multiple questions on cardiorespiratory symptoms from the Midlife Women’s Symptom Index in both studies. Characteristics of the women were assessed using multiple questions on background characteristics and menopausal and health/disease status in both studies. The data analysis was conducted using hierarchical clustering methods and multinomial logistic regression analyses.

The characteristics of midlife women with high cardiorespiratory symptoms were: non-Asian American, young, low-incomed, and pre-menopausal (p<0.05). Compared with midlife women with low cardiorespiratory symptoms, those with high cardiorespiratory symptoms were more likely be low incomed, pre-menopausal, and with an existing diagnosed disease (adjusted OR, 2.05, 2.30, and 1.59, respectively). Among those with high cariorespiratory symptoms, there existed racial/ethnic differences in their prevalence of symptoms (F=7.19; p<0.01); Asian Americans had a significantly lower prevalence of cardiorespiratory symptoms compared with other racial/ethnic groups in the U.S. (p<0.01).

This study reports specific characteristics of midlife women with high cardiorespiratory symptoms during the menopausal transition, which include race/ethnicity, socioeconomic status, age, menopausal status, and existing diagnosed disease(s).  These characteristics need to be considered in future research and health care for midlife women during the menopausal transition.