The influence of mental stress on blood flow is well-known, but a recent study suggests that young women with heart disease may experience the effects of stress more significantly than male or older counterparts. Since coronary heart disease (CAD) is the leading cause of deaths in Americans, and since younger women have higher rates of CAD complications and deaths, it is possible these findings offer a piece of the puzzle behind why this is the case.
In Brief: Mental Health and Heart Disease
Mental stress-induced myocardial ischemia (MSIMI) is the phrase used to describe reduced blood flow to the heart brought on by emotional or mental stressors. Myocardial ischemia is capable of causing a heart attack, so anything capable of influencing its severity or development is worth looking at.
Mental stress effects are sometimes lump results together as a subtype of conventional stress and, in certain circumstances, this makes sense. After all, mental stress and conventional stress can occur at the same time and ischemia is actually much more common in cases of conventional stress testing. However, since MSIMI can occur independent of conventional stress, the researchers felt it was worth looking at in isolation.
The study had 686 participants, 191 of whom were women, all aged between 34 and 79 years old and who had CAD. The participants all had stable heart disease, though individual histories were more varied and had to be controlled for. The men and women were assigned to deliver a speech on an assigned topic in front of a crowd and their hearts were imaged prior to and after the presentations. In order to heighten the mental stress, the audience was instructed to respond unfavorably.
When compared, it was found that 33% of the younger women (those under age 50) showed MSIMI compared to only 8% of the young men. When older men and women were compared, their results were roughly the same and still below those of the younger women. Due to how small the female group was compared to the male group, the researchers encourage caution with regards to how the results are interpreted. They do note, however, that the much large subgroup of women aged 51-60 showed a similar age-related effect. In other words, the younger the women were, the more vulnerable to MSIMI they were when compared to older women or equivalent men.
What This Means
It still isn’t understood why young women are more likely to die or have adverse events from heart disease, but these findings do help add pieces to the puzzle if they get confirmed. The effects of mental stress alone on blood flow is not as explored as other stressors, so the implication that young women are more vulnerable to MSIMI could have real benefits. As the researchers suggested, doctors with young female patients who have CAD could be encouraged to talk to their patients about stress in their lives and keep an ear out for indications of mental stress in particular.
Wokhlu, A., et. al., “Mental Stress and Myocardial Ischemia: Young Women at Risk,” Journal of the American Heart Association, 2016; 10.1161/JAHA.116.004196.