16 Feb Mental Stress Linked To Poor Heart Attack Recovery For Women
Harlan M Krumholz MD, SM
Harold H. Hines, Jr. Professor of Medicine (Cardiology) and Professor of Faculty of Arts and Sciences, of Investigative Medicine and of Public Health (Health Policy); Co-Director, Clinical Scholars Program; Director, Yale-New Haven Hospital Center for Outcomes Research and Evaluation New Haven, CT 06510
Medical Research: What is the background for this study? What are the main findings?
Response: Prior research of heart attack has mostly examined older patients, while few studies have focused on younger patients. Although we know that younger women differ from men and older patients in heart attack etiology and mortality, there is limited data on non-mortality outcomes of younger women and factors influencing their recovery. Mental stress is a particularly relevant factor for younger women as prior research showed higher stress in women than in men and an inverse association between age and stress. Therefore, in this study, we compared women and men 18-55 years old with heart attack and examined gender difference in mental stress and its potential role in explaining the worse recovery in women.
We addressed these questions using data from the Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) project, which is the largest prospective observational study of young and middle-aged women and men with heart attack and has comprehensive information on patients’ clinical and psychosocial characteristics. Our findings showed significantly higher stress in women than in men. Moreover, mental stress is associated with worse recovery in multiple health outcomes 1 month after heart attack, such as angina-specific and overall quality of life. The greater stress in women may partially contribute to their worse recovery.
Medical Research: What should clinicians and patients take away from your report?
Response: Clinicians need to be vigilant about patients’ status of psychological stress, especially among younger women patients. Incorporating screening tests and teaching patients appropriate coping skills could be beneficial. We also need to recognize that women and men are burdened by different stressors, and should take a gender-specific approach when helping patients manage psychological stress.
From patients’ perspective, they need to be aware of the adverse impact of mental stress on heart attack recovery. Avoiding stressful situations and learning appropriate coping skills may help reduce stress and its adverse health impact.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: Our findings suggest many areas for further investigation. For example, the current study assessed patient outcomes at 1 month after heart attack. We need to determine whether similar relationship holds for longer term recovery. Moreover, although we found a strong association between mental stress and poor recovery, further research is needed to understand the underlying mechanisms of the sex-stress-recovery relationship. That information is crucial for designing the most appropriate interventions to improve patient outcome.
Xu, H. Bao, K. Strait, J. A. Spertus, J. H. Lichtman, G. D’Onofrio, E. Spatz, E. M. Bucholz, M. Geda, N. P. Lorenze, H. Bueno, J. F. Beltrame, H. M. Krumholz. Sex Differences in Perceived Stress and Early Recovery in Young and Middle-Aged Patients with Acute Myocardial Infarction. Circulation, 2015; DOI: 10.1161/CIRCULATIONAHA.114.012826
MedicalResearch.com Interview with:, & Xiao Xu, PhD Assistant Professor (2015). Mental Stress Linked To Poor Heart Attack Recovery For Women MedicalResearch.com