Why Women’s Hearts are more Vulnerable to Stress
Ladies, you already know that chronic stress isn’t good for you. But did you know that it can affect your heart more seriously than it affects the hearts of the men in your life?
We all worry about our guys falling victim to heart attacks, and we have good reason to—statistics show that between the ages of 18 and 55, men are more likely than women to suffer a heart attack. (Women make up for it as they get older, evening out the numbers and making heart disease the number-one killer for both genders.)
Yet according to recent research, women may be more vulnerable to the effects of stress on their hearts. Here’s more and how you can increase your odds of staying healthy.
Women More at Risk for Myocardial Ischemia
Previous research has found that compared with men, women who already have heart disease are more likely to suffer a from what is medically called “myocardial ischemia”—lack of blood flow to the heart. When the heart doesn’t get enough blood, it doesn’t get enough oxygen, which increases risk of a heart attack and other serious complications.
Myocardial ischemia usually occurs because the arteries feeding the heart become narrowed or blocked, often due to coronary artery disease, or the gradual buildup of cholesterol and plaque in the arteries. The condition can develop slowly over time, or occur quickly if a blood clot suddenly forms.
Symptoms of myocardial ischemia are similar to those of a heart attack, and include shoulder or arm pain, shortness of breath, sweating, fatigue, neck or jaw pain, and a racing heartbeat. Without treatment, it can lead to a full-blown heart attack or heart failure.
A number of studies have found that women seem to be more at risk for this type of heart problem, particularly in response to stress. In the Psychophysiological Investigations of Myocardial Ischemia Study, mental-stress-induced ischemia “predicted increased risk for all-cause morality” in patients with coronary artery disease. In the Women’s Ischemia Syndrome Evaluation, researchers again found an association between stress and premature mortality.
In 2016, scientists performed another study on women with coronary artery disease under the age of 50. They found that mental-stress induced myocardial ischemia (MSIMI) was more frequent in young women compared to younger men, and even compared to older women.
When trying to figure out why, scientists theorized that sex hormones may be involved, but otherwise couldn’t point a finger at the reason for the connection. They did conclude that stress management techniques might help.
Study Finds Stress Affects Women’s Hearts Differently
In this new study, however, published in December 2017, researchers say they’ve finally found out why women are more vulnerable to MSIMI. It seems that when we experience stress, our blood vessels respond by tightening up or constricting more than men’s do.
You know how your muscles respond to stress—they get tight and taut, which can cause you pain and headaches later on in the day. According to this study, our blood vessels do the same. (Could we call it a “blood vessel ache?”)
For the study, researchers analyzed data from 678 people with coronary artery disease. Again, this is the disease that results from the gradual buildup of plaque that narrows and stiffens the arteries. They then put each patient through a stressful event—in this case, public speaking! You can imagine how the prospect of getting up and talking to a group may affect you. It’s one of the most common activities associated with stress.
Each individual, then, engaged in public speaking, and during their talk, the researchers used heart imaging to see if the experience triggered myocardial ischemia. They found that it did in 15 percent of the patients. Interestingly, men and women were affected at a similar rate. The difference, however, was in what caused the myocardial ischemia.
In men, the mental stress triggered a rise in blood pressure and heart rate, which increased the workload on the heart. In women, however, the stress caused the small blood vessels to constrict. This can cause an increase in what doctors term “afterload,” the force the heart has to exert to pump blood out of the heart.
This isn’t a good thing, as typically during stress, what we want to have happen is for the blood vessels to relax and open up or “dilate,” so that more blood can get where it needs to go. (When we’re stressed, we typically need more blood, not less.) Yet if the blood vessels constrict, there are areas in the heart that suffer from reduced blood flow. Constriction of blood vessels in and around the heart can cause problems, but so can the constriction of blood vessels elsewhere in the body.
“Constriction of peripheral vessels can also induce ischemia in the heart indirectly,” said Viola Vaccarino, M.D., Ph.D. and senior author of the study, “because the heart has to pump against increased resistance.”
Vaccarino adds that the findings are important, as previous studies have shown that “a reduction in blood supply to the heart (ischemia) during mental stress doubles the risk of heart attack or death from heart disease.”
How Women Can Protect Their Hearts
Clearly experiencing chronic stress isn’t good for men or women, but now we can understand more why it can be particularly dangerous for women, especially women who already have heart disease.
What can you do to protect yourself? Adopt those healthy lifestyle habits you’ve heard about a million times: eat a wholesome, nutritious diet, exercise regularly, avoid smoking, and try to maintain a healthy weight. But in addition, considering these findings, you may want to do more to manage the stress in your life.
Obviously we’re going to have stress. We can’t avoid it entirely. But we can incorporate more stress-relieving activities into our days. Vaccarino warned that both men and women need to talk to their doctors about ways to reduce stress, and to reach out for professional help with depression and anxiety when needed.
“The main message is,” she said, “we need to find healthy ways to cope with stress.”
If you’re looking for new ways to de-stress, there are many options, including taking a walk in the park, journaling, spending time with a good friend or a beloved pet, talking to a counselor, engaging in art or music therapy, crafting, and more. You may want to add yoga to that list, however.
According to a 2014 study, yoga may help lower heart disease risk as much as regular exercise, like brisk walking. The practice helped the participants lose weight, lower their blood pressure, and lower their levels of harmful LDL cholesterol. And in an exciting recent study, researchers found that yoga and meditation could not only help you relax and reduce stress in the moment, but could even reverse stress-related changes in genes linked to poor health and depression.
“Heart Attack Risk Factors: Women vs. Men,” GoRedforWomen.org, https://www.goredforwomen.org/about-heart-disease/heart_disease_research-subcategory/heart-attack-risk-factors-women-vs-men/.
Samaah Sullivan, et al., “Sex Differences in Hemodynamic and Microvascular Mechanisms of Myocardial Ischemia Induced by Mental Stress,” Arteriosclerosis, Thrombosis, and Vascular Biology, 2017; DOI: 10.1161/ATVBAHA.117.309535, http://atvb.ahajournals.org/content/early/2017/12/20/ATVBAHA.117.309535.
Anita Wokhlu, Carl J. Pepine, “Mental Stress and Myocardial Ischemia: Young Women at Risk,” JAMA, August 24, 2016; 5:e004196, http://jaha.ahajournals.org/content/5/9/e004196.
Amy Norton, “Are Women’s Hearts More Vulnerable to Stress?” USNews, December 21, 2017, https://health.usnews.com/health-care/articles/2017-12-21/are-womens-hearts-more-vulnerable-to-stress.
“Mental stress-induced constricted blood vessels more likely in women,” American Heart Association, [Press Release], December 21, 2017, https://eurekalert.org/pub_releases/2017-12/aha-msc121917.php.
Paula Chu, et al., “The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials,” European Journal of Preventive Cardiology, December 15, 2014, http://journals.sagepub.com/doi/full/10.1177/2047487314562741.
Ivana Buric, et al., “What is the Molecular Signature of Mind-Body Interventions? A Systematic Review of Gene Expression Changes Induced by Meditation and Related Practices,” Front Immunol., June 16, 2017; https://www.frontiersin.org/articles/10.3389/fimmu.2017.00670/full.