Women May Have More Cardiac Ischemia Than Men In Response To Mental Stress

Zainab Samad, M.D., M.H.S. Assistant Professor of Medicine Duke University Medical Center Durham, North CarolinaMedicalResearch.com Interview with:
Zainab Samad, M.D., M.H.S.
Assistant Professor of Medicine
Duke University Medical Center
Durham, North Carolina


Medical Research: What are the main findings of the study?

Dr. Samad: This was a sub study of REMIT, an NHLBI funded study. Our research team headed by Dr. Wei Jiang conducted the REMIT study between 2006-2011 at the Duke Heart Center. We found that women and men differ significantly in their physiological and psychological responses to mental stress. We explored sex differences across various domains felt to have implications towards cardiovascular disease pathophysiology and prognosis. We found that women had greater negative emotion, less positive emotion, while men had greater blood pressure increases in response to mental stress. On the contrary, women showed greater platelet reactivity compared to men in response to mental stress. A greater frequency of women had cardiac ischemia in response to mental stress compared to men.

Medical Research: What was most surprising about the results?

Dr. Samad: Two findings were interesting.

1. A higher prevalence of cardiac ischemia in response to mental stress in women and

2. Greater platelet reactivity exhibited by women compared to men in response to mental stress. Both findings carry implications for future research in this area.

Medical Research: What should clinicians and patients take away from your report?

Dr. Samad: Physiological differences between men and women in their response to mental or psychosocial stress should be recognized during cardiovascular risk assessment.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Samad: The specific role of mental stress induced myocardial ischemia in the prognosis of CVD needs to be evaluated, particularly in women. Disease modifying targets need to be researched in this area.

Citation:
Sex Differences in Platelet Reactivity and Cardiovascular and Psychological Response to Mental Stress in Patients With Stable Ischemic Heart Disease: Insights From the REMIT Study

Journal of the American College of Cardiology October 13 2014

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