Role of Stress in Heart Disease Varies by Gender

New research suggests we still have a lot to learn on the way mental stress influences heart disease.

The study, published in the Journal of the American College of Cardiology, was a part of a larger review on the impact of escitalopram (Lexapro) on heart disease induced by mental stress.

Duke Heart Center researchers discovered that among men and women diagnosed and being treated for heart disease, mental stress elicits different cardiovascular, and psychological reactions.

Investigators examined 56 women and 254 men diagnosed with heart disease. After undergoing baseline testing, participants carried out three mentally stressful tasks — a mental arithmetic test, a mirror tracing test, and an anger recall test — followed by a treadmill exercise test.

Researchers used echocardiography to study changes in the heart during mental stress tasks and rest periods between tests. Evaluators also took blood samples, and measured blood pressure and heart rate.

The investigators found that while men had more changes in blood pressure and heart rate in response to the mental stress, more women experienced myocardial ischemia, or decreased blood flow to the heart.

Women also experienced increased platelet aggregation, which is the start of the formation of blood clots, more than men.

The women compared with men also expressed a greater increase in negative emotions and a greater decrease in positive emotions during the mental stress tests.

“The relationship between mental stress and cardiovascular disease is well-known,” said the study lead author Zainab Samad, M.D., M.H.S., assistant professor of medicine at Duke University Medical Center in┬áNorth Carolina.

“This study revealed that mental stress affects the cardiovascular health of men and women differently. We need to recognize this difference when evaluating and treating patients for cardiovascular disease.”

“At this point, further studies are needed to test the association of sex differences in the heart’s responses to mental stress and long term outcomes,” Samad said.

Investigators believe the study demonstrates the need for a better understanding of the way mental stress can influence biological changes among genders.

“This study also underscores the inadequacy of available risk prediction tools, which currently fail to measure an entire facet of risk, i.e. the impact of negative physiological responses to psychological stress in both sexes, and especially so among women.”

Source: American College of Cardiology