Women, stress and the risk of heart disease

Along with poor diet, lack of exercise and smoking, unmanaged stress may increase the risk for heart disease.

Now medical experts are discovering that mental stress affects women in different, and in some cases, more devastating ways, especially if they already have coronary conditions.

One study that looked at adults with heart disease found that women who have mental stress are more prone than men to decreased blood flow to the heart (myocardial ischemia), which could lead to a heart attack.

Other research suggests that women younger than 50 who had a recent heart attack and experience mental stress are more likely to have reduced blood flow than men of the same age with the same history.

This is of great concern to medical experts.

Women have a higher risk of developing mental stress-induced heart dysfunction, according to Dr. Zainab Samad, assistant professor of medicine, Duke University, Durham, N.C.

Health researchers are beginning to look at the differences and to identify why some women are so negatively affected.

Duke medical experts reviewed data from a previous study on men and women with decreased blood flow to the heart and stress.

They discovered gender differences in blood platelet formation.

Women experienced greater blood platelet clumping, which could cause clots, even though most of the volunteers were on anti-clumping medications, according to Dr. Samad.

In the Emory University study on adults under 50 who had recent heart attacks, women were about twice as likely as men to experience mental stress-induced blood flow reduction.

“I was not surprised about the results in younger women, but the extent did surprise me,” says Dr. Viola Vaccarino, Ph.D., professor and chair of the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Ga.

She doesn’t have a definite answer about what it is that makes younger women vulnerable.

If it is mental stress, then the question is why some women are better able than others to handle it.

Dr. Vaccarino hopes to develop a mental stress test to identify those at risk.

For now it’s difficult to gauge stress and determine who will be more susceptible.

“You can’t put numbers on it as we would how much you weigh, how much you exercise or whether you smoke,” says Dr. Charles Katzenberg, cardiologist, University of Arizona Sarver Heart Center, Tucson, Ariz.

In experiments stress is induced. The volunteers’ responses may indicate the degree to which they have stress in their lives, according to Dr. Katzenberg, co-founder of the HEART Series, a 12-week program to promote heart health.

But even if you can’t determine whether your particular stressors put you at risk, you can take steps to reduce your vulnerability.

It starts with a walk.

“It’s been shown to reduce stress and improve cardiovascular function. It’s clearly important, especially for high-risk women to find time every day, or at least every other day to go to the gym, take long walks. That’s my recommendation at this point,” Dr. Vaccarino says.