Mental Stress Linked To Poor Heart Attack Recovery For Women

Xiao Xu, PhD Assistant Professor Department of Obstetrics, Gynecology and Reproductive Sciences Yale University School of Medicine andMedicalResearch.com Interview with:
Xiao Xu, PhD Assistant Professor
Department of Obstetrics, Gynecology and Reproductive Sciences
Yale University School of Medicine and

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 06510Harlan 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.

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Link Between Stress and Fertility Examined

Anna Geraghty Department of Integrative Biology University of California, Berkeley, Berkeley,MedicalResearch.com Interview with:
Anna Geraghty

Department of Integrative Biology
University of California, Berkeley, Berkeley,

Medical Research: What is the background for this study? What are the main findings?

Response: RFRP3 in mammals has been well characterized as a negative regulator of the hormonal reproductive axis. It shuts down release of gonadotropins necessary for successful reproduction, similar to how stress inhibits reproduction. Our lab has previously shown that stress can directly regulate RFRP3 levels in males-both acute and chronic stress lead to an upregulation of RFRP3 levels in the male rat. As a followup to that study, we were interested in looking at whether this response was similar in females, and how that may affect long term fertility. We found that chronic (18 days) of stress led to an increase in RFRP3 levels all all stages of the estrous cycle. This increase was also sustained for at least 4 days, or one whole estrous cycle, after the stress ended- the equivalent to a month menstrual cycle in humans. In rats that were stressed and then allowed to recover for 4 days, animals that were stressed were significantly less successful at reproducing- 76% success rate in controls compared to 21% in the stressed animals. This was a result of a combination of deficits in the mating process- less stressed animals successfully copulated, those that did successfully mate had fewer pregnancies, and gave birth to smaller litters. However, utilizing an inducible virus to knockdown RFRP levels in the hypothalamus specifically during the stress period prevented all of these problems- stressed animals without stress-induced RFRP3 increases looked indistinguishable to controls.

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Cardiac Defect of Hypertrophic Cardiomyopathy Aggravated By Life Stresses

Sakthivel Sadayappan, PhD, MBA Associate Professor Department of Cell and Molecular Physiology Loyola University Chicago Health Sciences Division Maywood, IL  60153-5500, USA.MedicalResearch.com Interview with:
Sakthivel Sadayappan, PhD, MBA
Associate Professor Department of Cell and Molecular Physiology
Loyola University Chicago Health Sciences Division
Maywood, IL  60153-5500, USA.

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Sadayappan: Hypertrophic cardiomyopathy (HCM) is the most common form of genetic heart defect, affecting 1 in 500 people in the general population. HCM results in excessive thickening of heart muscle without an obvious cause, such as hypertension or exercise stress. Often, HCM results in sudden cardiac arrest as a result of cardiac arrhythmia. Electrocardiogram, echocardiogram and cardiac magnetic resonance imaging are commonly used to diagnose HCM. However, genetic defects in more than 10 genes could also cause HCM, and standard screening for these genes is readily available. Notwithstanding our ability to diagnose the disease, a major challenge arises from its heterogeneity. That is, individuals with the same genetic defect often present with different symptoms, ranging from no symptoms at all to severe heart enlargement. Therefore, treatment options vary from person to person, and, at present, no permanent cure is available for HCM. Beta-blockers, calcium antagonists and anti-arrhythmic drugs are currently being used to manage the disease. However, scientists must discover the reasons that explain why some people experience more severe symptoms than others.

In today’s modern world, people are afflicted with stresses including, for example, diabetes, hypertension, hyperlipidemia (high cholesterol), and alcoholism. Therefore, we have hypothesized that additional cardiac stresses can aggravate the onset of Hypertrophic cardiomyopathy. To prove our hypothesis, we used a mouse model having a genetic defect known to affect cardiac muscle contractility. We subjected these mice to severe cardiac stress over a period of 12 weeks. Compared with normal mice, we found that the mutant mice showed significant cardiac abnormalities, including those associated with HCM. Thus, this demonstrated, for the first time, that additional cardiac stress applied in the presence of known genetic defects exacerbates the onset of HCM. Continue reading

Adaptive Behaviors To Stress Can Be Transmitted Across Generations

Prof Dr Isabelle Mansuy Lab of Neuroepigenetics University/ETH Zürich Brain Research Institute Zürich, SwitzerlandMedicalResearch Interview with:
Prof Dr Isabelle Mansuy

Lab of Neuroepigenetics University/ETH Zürich
Brain Research Institute Zürich, Switzerland

 

MedicalResearch: What is the background for this study? What are the main findings?

Prof. Mansuy: It is recognised that being exposed to traumatic stress in early life increases the susceptibility to psychiatric and metabolic diseases later in life. This is true for people directly exposed but also for their progeny across generations. It is also known that sometimes, stress exposure in early life can help an individual develop response strategies and be better prepared for later stressful experiences. The mechanisms of such beneficial effects and the question of whether they can be transmitted or not are not known. This study in mice was designed to answer these questions. The main findings are that exposure to traumatic stress of mouse newborns makes the animals and their progeny more efficient in challenging tasks when adult. For instance, they are more able to adapt to rules that change in a complex task to get a water ration when they are thirsty. This suggests more adaptive behaviours in challenging situations that are transmitted across generation. The study identifies the mineralocorticoid receptor, a stress hormone receptor in the brain, as an important molecular mediator of this effect and demonstrates that its expression is altered in the brain by epigenetic mechanisms.

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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.
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Future Uncertainty, Financial Issues Add to Stress in College Students

MedicalResearch.com Interview with:
Ashley Merianos, PhD, CHES
Health Promotion & Education Program
University of Cincinnati
Cincinnati, Ohio   45221-0068

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

Dr. Merianos: Our study found that college students are unhappy and have difficulty with stress management. Specifically, the majority (61.0%) of participants reported having high stress, and were most stressed about school, lack of time, and with their future career. Although high levels of stress were reported, most (72.0%) students reported low frequency in using stress management techniques. Our study shows that students who reported low happiness reported higher stress levels and lower emotional closeness to others. Continue reading

Civilian Stress Linked To Problem Drinking In Military

Magdalena Cerdá, DrPH MPH Assistant Professor, Department of Epidemiology Mailman School of Public Health Columbia University New York, NY 10032-3727MedicalResearch.com Interview with:
Magdalena Cerdá, DrPH MPH
Assistant Professor, Department of Epidemiology
Mailman School of Public Health
Columbia University
New York, NY 10032-3727

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

Dr. Cerdá: We evaluated 1,095 Ohio National Guard soldiers, who had primarily served in Iraq and Afghanistan between 2008 and 2009 to determine the effect of civilian stressors and deployment-related traumatic events and stressors on post-deployment alcohol use disorder.

Participants were interviewed three times over 3 years about alcohol use disorder, exposure to deployment-related traumatic events like land mines, vehicle crashes, taking enemy fire, and witnessing casualties, and about experiences of civilian life setbacks since returning from duty, including job loss, legal problems, divorce, and serious financial and legal problems.

We found that having at least one civilian stressor or a reported incident of sexual harassment during deployment raised the odds of alcohol use disorders. In contrast, combat-related traumatic events were only marginally associated with alcohol problems.
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Psychological Distress Increases Risk of Diabetes in Pre-Diabetics

Marianna Virtanen Finnish Institute of Occupational Health Helsinki, FinlandMedicalResearch.com Interview with:
Marianna Virtanen PhD
Finnish Institute of Occupational Health
Helsinki, Finland

MedicalResearch: What are the main findings of the study?

Dr. Virtanen: We examined whether psychological distress predicts incident type 2 diabetes and if the association differs between populations at higher or lower risk of type 2 diabetes. We used a clinical type 2 diabetes risk score to assess future diabetes risk and in addition, participants’ prediabetes status. We found that psychological distress did not predict future type 2 diabetes among participants who were normoglycemic and among those with prediabetes combined with a low diabetes risk score. However, psychological distress doubled the risk of type 2 diabetes among participants with prediabetes and a high diabetes risk score.

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Traumatic Stress Effects In Early Life Can Be Transmitted To Offspring

MedicalResearch.com Interview with:
Prof Dr Isabelle Mansuy Lab of Neuroepigenetics University/ETH Zürich Brain Research Institute Zürich SwitzerlandProf Dr Isabelle Mansuy
Lab of Neuroepigenetics
University/ETH Zürich
Brain Research Institute
Zürich Switzerland

MedicalResearch.com: What are the main findings of the study?

Prof. Mansuy: The mains findings are that the transmission of the effects of traumatic stress in early life involves small non-coding RNAs in sperm. The study shows that some microRNAs are in excess in the sperm of adult males subjected to trauma during early postnatal life, but are also altered in the brain and in blood, and that these alterations are associated with behavioral and metabolic symptoms including depressive behaviors, reduced risk assessment and altered glucose/insulin metabolism. Injecting sperm RNA in fertilized oocytes reproduces these symptoms and confirm that RNA are the responsible factors.

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