The death of a loved one, a life-threatening illness, or financial issues can be stressful events for anyone, but new research suggests they may have an especially negative effect on the heart health of middle aged and older women.
Researchers looked at 548 women, 267 of whom had a history of heart attack and 281 who did not, to determine possible psychological risk factors for heart attacks.
"What we found was that by comparing women who reported having history of heart attack to women who did not have history of heart attack, in general, traumatic life events were related to higher a likelihood of heart attack," senior study author Michelle Albert, MD, MPH, Director of the Center for the Study of Adversity and Cardiovascular Disease at the University of California Medical Center, San Francisco, told CBS News. "Women who earned less than $50,000 per year were also likely to have a heart attack due to negative life events."
The sample of women came from a larger group of nearly 27,0oo women, with an average age of 56, who participated in the ongoing national Women's Health Study at Brigham and Women's Hospital. Participants were asked questions about stressful life events, including legal problems, marital infidelity, being fired from a job, unemployment, financial issues, death of a loved one, and life-threatening injuries or illnesses to themselves or a loved one. Researchers followed up with the women for an average of nine years.
The results showed that a traumatic life event increased the odds of heart attack by more than 65 percent among middle-aged and older women. A history of financial struggle - defined as an annual income of less than $50,000 per year - was associated with a 24 percent higher chance of heart attack.
While stress is a known risk factor for cardiovascular disease and heart attack, the researchers said they wanted to explore specific types of stressful events that may have an impact on women's heart health. While stress also threatens men's heart health, this study highlights the vulnerability of this particular age group in women.
"We don't know whether women are more physiologically vulnerable, as some prior research suggests that decreases in blood flow to the heart caused by acute mentally-induced stress is more common in women and individuals with less social support," Albert said in a statement. "At the biological level, we know that adverse experiences including psychological ones can lead to increased inflammation and cortisol levels. However, the interplay between gender, heart disease and psychological factors is poorly understood." And while the risk of cardiovascular disease increases for women after they hit menopause, most of the prior research related to negative life and heart attack has been done in men and persons who have a history of heart attack.
One of Albert's former patients, Pat Benson, 66, of Boston, knows the toll stress can take on overall health. After she suffered a severe blockage and had two stents put in when she was 55, both of her parents became ill with pancreatic cancer and she cared for them until the end of their lives. "It was very overwhelming," she told CBS News. "I took care of my parents, then after my father passed away, it was the selling of the house. I was taking on everything myself. I didn't really think of how the stress could affect my health until my family started voicing concern." She and Albert discussed what was going on in her life and steps she could take to reduce stress to try to keep her heart healthy.
Albert said she hopes that the study's findings will inspire other cardiologists to begin having open discussions with their patients about stressful events in their lives, something she routinely does in her practice. "Typically, doctors don't ask their patients about stressors in their lives unless the patients bring it up," she said. "This data suggests it should be part of a routine cardiovascular assessment."
The research, from the American Heart Association's Quality of Care and Outcomes Research 2015 Scientific Session, is being published in the AHA Journal, Circulation, Cardiovascular Quality and Outcomes.