Women's risk of cardiovascular disease increases upon menopause. Hot flashes, a common symptom associated with menopause, lead both to discomfort and elevated blood pressure. There are population differences in the age at which menopause is reached and in the frequency with which symptoms associated with menopause are reported. The current study proposes to examine ethnic differences in the age at menopause and experience of hot flashes in Hawaii's multiethnic population. The project has three components: a mailed survey of a random sample of adult women in Hilo Hawaii (N=1500)which includes questions about demographics, health and menopausal experience; an ambulatory monitoring of blood pressure and skin conductance over a 24-hour period in a subsample (N=200) of these women that will also include collection of a blood sample for lipid analysis; and a laboratory investigation of objective and subjective measures of hot flashes and their physiological concomitants in the subsample of women under conditions that often induce hot flashes. Two study hypotheses are that there are significant ethnic differences in the percentage of women who report experiencing hot flashes, and that the peri- and post-menopausal women who report experiencing hot flashes will have higher mean daily BP and elevated sleeping BP relative to same-age women who do not, or rarely, experience hot flashes. The implication of the research is that differences in the experience of menopause and its symptoms in peri- and post-menopausal women may explain some of the ethnic variation in cardiovascular health risk.