(Press-News.org) Contact information: Jennifer Johnson
jrjohn9@emory.edu
404-727-5696
Emory Health Sciences
Mental stress + heart disease: Stronger presence in women under 50
Patients with recent heart attack tested with public speaking task
Researchers have found that women younger than 50 with a recent heart attack are more likely to experience restricted blood flow to the heart (myocardial ischemia) in response to psychological stress.
The finding may partly explain why younger women who are hospitalized after a heart attack face a greater risk of complications and dying, compared to men of the same age.
The results are scheduled to be presented Wednesday, Nov. 20 at the American Heart Association Scientific Sessions meeting in Dallas.
Researchers at Emory University have been studying the responses of patients who recently had a heart attack to exercise stress and mental stress, in the form of public speaking on an emotional topic. They have found that women age 50 and below are more likely to experience mental stress-induced ischemia, compared to men of the same age (52 percent compared to 25 percent).
The MIMS (Myocardial Infarction and Mental Stress) study included 49 men and 49 women, age-matched pairs who all had a heart attack in the last six months. Their ages ranged from 38 to 59. Among study participants older than 50, there were no significant sex differences in mental stress-induced ischemia;, however, men older than 50 had a rate of exercise-induced ischemia that was twice as high as women of a similar age.
"This is the first study to examine the cardiovascular effects of psychological stress as a possible mechanism for the greater mortality after myocardial infarction among younger women," says study leader Viola Vaccarino, MD, PhD, professor and chair of the Department of Epidemiology, Rollins School of Public Health.
"We saw a dramatic difference in mental stress-induced ischemia specifically in younger women. In addition, when ischemia was graded in a continuous way, we saw that it was twice as severe among the younger women."
Women who experience a heart attack before age 50 are relatively rare, suggesting that perhaps those who do simply have more severe heart disease. However, even when investigators adjusted for different rates of traditional heart disease risk factors such as smoking and diabetes, the disparity remained. In fact, women tended to have less severe coronary artery disease, measured by examining the degree of blockage in their coronary arteries.
One possible explanation the Emory investigators considered was a higher burden of psychosocial stress, Vaccarino says. In the study, the younger women were more often poor, of minority race, with a history of sexual abuse and with higher levels of depressive symptoms.
"Yet if we look at the statistics, factors such as poverty, race and depression do not explain the difference," she says. "Yes, women have more stressors. But our data show that women also may be more vulnerable to the effects of mental stress on the heart."
"This could be an added stimulus to the medical community to pay more attention to the emotional factors in cardiac patients. We are now taking a closer look at potential physiological factors that account for the additional susceptibility in younger women."
Emory researchers working with Vaccarino have identified two areas where there are specific differences in younger women who had a recent heart attack: inflammation and heart rate variability, a measure of the responsiveness of the autonomic nervous system. Low heart rate variability has been previously linked to greater heart disease risk.
The inflammation data is being presented in a poster by postdoctoral researcher Cherie Rooks, PhD on Sunday, Nov. 17 and the heart rate variability data in a poster by assistant professor Amit Shah, MD on Tuesday, Nov. 19.
Interleukin-6 is a marker of inflammation that goes up and down quickly depending on someone's environmental exposures including mental stress, even in healthy individuals. In the MIMS study, women age 50 and below had much higher levels of IL-6 in their blood, compared to age-matched men, both before the mental stress test and afterwards. Women and men older than 50 had similar levels of IL-6.
Heart rate goes up in response to physical or psychological stress, but the beats also become more evenly spaced. Heart rate variability is a measure of how much moment-to-moment fluctuation is present; higher heart rate variability is a marker of a more flexible, and thus healthier, autonomic system. In the MIMS study, younger women had their heart rate variability dip more in response to stress, compared to men the same age. This is additional evidence that young women after a heart attack may be more vulnerable to the adverse effects of psychological stress on the heart.
Vaccarino and her colleagues are continuing to investigate mental stress-induced ischemia, including how it affects mortality and complication rates, in a second phase of the MIMS study at Emory, which will include a larger sample with patient follow-up.
###
How the study was conducted
The mental stress test part of the study was a public speaking task involving an emotional topic. Participants were asked to imagine a real-life stressful situation, such as a close relative been mistreated in a nursing home. They had to quickly prepare a speech and deliver it in front of a video camera and an audience wearing white coats, while their blood pressure and other vital signs were monitored.
Immediately afterwards, cardiac imaging was performed to assess blood flow within the heart via SPECT (single photon emission computed tomography). On a separate day, study participants performed a standard exercise test on a treadmill; a few were unable to exercise at a high heart rate and had to have a "pharmacological" stress test with a drug that dilates coronary arteries.
The research was supported by the National Heart Lung and Blood Institute and the National Institute for Mental Health (R21HL093665, R21HL093665-01A1S1, R01 HL109413, K24HL077506, and K24 MH076955).
Mental stress + heart disease: Stronger presence in women under 50
Patients with recent heart attack tested with public speaking task
2013-11-20
ELSE PRESS RELEASES FROM THIS DATE:
Top hospitals reduce readmissions by preventing complications across all diagnoses
2013-11-20
Top hospitals reduce readmissions by preventing complications across all diagnoses
Checking back into the hospital within 30 days of discharge is not only bad news for patients, but also for hospitals, which now face financial penalties for high readmissions. The key ...
Financial decision makers need weather and climate information to manage risks
2013-11-20
Financial decision makers need weather and climate information to manage risks
Maximizing returns on financial investments depends on accurately understanding and effectively accounting for weather and climate risks, according to a new study by the American ...
USC Viterbi engineers cut time to 3D-print heterogeneous objects from hours to minutes
2013-11-20
USC Viterbi engineers cut time to 3D-print heterogeneous objects from hours to minutes
New 3D printing process speeds up fabrication of multiple-material objects
Researchers at the USC Viterbi School of Engineering have developed a faster 3D printing process and ...
Focusing on faces
2013-11-20
Focusing on faces
Researchers find neurons in amygdala of autistic individuals have reduced sensitivity to eye region of others' faces
Difficulties in social interaction are considered to be one of the behavioral hallmarks of autism spectrum ...
Spanish scientists identify a new ancestral enzyme that facilitates DNA repair
2013-11-20
Spanish scientists identify a new ancestral enzyme that facilitates DNA repair
PrimPol allows cells to make copies of their DNA even when it is damaged, and prevents breaks in the chromosomes
Every day, the human body produces new cells to regenerate ...
Scientists create perfect solution to iron out kinks in surfaces
2013-11-20
Scientists create perfect solution to iron out kinks in surfaces
A new technique that allows curved surfaces to appear flat to electromagnetic waves has been developed by scientists at Queen Mary University of London.
The discovery could hail ...
Novel material stores unusually large amounts of hydrogen
2013-11-20
Novel material stores unusually large amounts of hydrogen
X-ray study reveals the formation of iridium trihydride at high pressure
This news release is available in German. An international team of researchers has synthesized a new material ...
Services fail to treat prisoners with schizophrenia -- increasing risk of violent reoffending
2013-11-20
Services fail to treat prisoners with schizophrenia -- increasing risk of violent reoffending
New research from Queen Mary University of London shows released prisoners with schizophrenia are three times more likely to be violent than other prisoners, ...
Study reveals higher levels of control and support at work increases wellbeing
2013-11-20
Study reveals higher levels of control and support at work increases wellbeing
Research from Queen Mary University of London reveals positive aspects of working life – such as high levels of control at work, good support from supervisors and colleagues, ...
The closest relatives of papaya are 4 species from Mexico and Guatemala
2013-11-20
The closest relatives of papaya are 4 species from Mexico and Guatemala
For many decades, researchers thought the closest relatives of papaya were certain trees from the Andes, the so-called highland papayas. A study employing DNA sequences from all species of the papaya ...
LAST 30 PRESS RELEASES:
Are lifetimes of big appliances really shrinking?
Pink skies
Monkeys are world’s best yodellers - new research
Key differences between visual- and memory-led Alzheimer’s discovered
% weight loss targets in obesity management – is this the wrong objective?
An app can change how you see yourself at work
NYC speed cameras take six months to change driver behavior, effects vary by neighborhood, new study reveals
New research shows that propaganda is on the rise in China
Even the richest Americans face shorter lifespans than their European counterparts, study finds
Novel genes linked to rare childhood diarrhea
New computer model reveals how Bronze Age Scandinavians could have crossed the sea
Novel point-of-care technology delivers accurate HIV results in minutes
Researchers reveal key brain differences to explain why Ritalin helps improve focus in some more than others
Study finds nearly five-fold increase in hospitalizations for common cause of stroke
Study reveals how alcohol abuse damages cognition
Medicinal cannabis is linked to long-term benefits in health-related quality of life
Microplastics detected in cat placentas and fetuses during early pregnancy
Ancient amphibians as big as alligators died in mass mortality event in Triassic Wyoming
Scientists uncover the first clear evidence of air sacs in the fossilized bones of alvarezsaurian dinosaurs: the "hollow bones" which help modern day birds to fly
Alcohol makes male flies sexy
TB patients globally often incur "catastrophic costs" of up to $11,329 USD, despite many countries offering free treatment, with predominant drivers of cost being hospitalization and loss of income
Study links teen girls’ screen time to sleep disruptions and depression
Scientists unveil starfish-inspired wearable tech for heart monitoring
Footprints reveal prehistoric Scottish lagoons were stomping grounds for giant Jurassic dinosaurs
AI effectively predicts dementia risk in American Indian/Alaska Native elders
First guideline on newborn screening for cystic fibrosis calls for changes in practice to improve outcomes
Existing international law can help secure peace and security in outer space, study shows
Pinning down the process of West Nile virus transmission
UTA-backed research tackles health challenges across ages
In pancreatic cancer, a race against time
[Press-News.org] Mental stress + heart disease: Stronger presence in women under 50Patients with recent heart attack tested with public speaking task