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Orlando, Fla. — A new study study suggests that mental stress can have an impact on blood vessels, and the risk among women with heart disease might be higher.

Past research found that women with heart disease are more likely to suffer “myocardial ischemia” in response to mental stress when compared with their male counterparts.

It refers to a reduction in blood flow to the heart, and it can raise the risk of potentially fatal heart complications.

Researchers in the new study, uncovered a reason for the phenomenon: When under psychological stress, women are more prone than men to having their blood vessels constrict.

Experts said the findings underscore some realities.

For some people, a daily walk or an app that teaches relaxation techniques might be enough. Others might need a referral to a mental health professional. Everybody have different sources of stress.

The study involved 678 people with coronary artery disease. That means “plaques” build up in larger arteries, sometimes causing symptoms like chest pain and breathlessness. It can also lead to a heart attack if a plaque ruptures and completely blocks an artery.

Each patient went through a mental stress test — public speaking — and researchers used heart imaging to see whether it triggered myocardial ischemia.

Overall, around 15 percent of all study patients had stress-induced ischemia — with men and women affected at a similar rate. But the underlying causes differed between the sexes.

In women, it was mainly caused by constriction in small blood vessels.   

When men developed ischemia, it was mainly because mental stress triggered a rise in blood pressure and heart rate — which boosted the heart’s workload.

Women are more likely than men to have “microvascular dysfunction.” That refers to problems in the small blood vessels that feed the heart. Those arteries are not clogged up with plaques, but they have damage that can impair blood flow. That high rate of microvascular dysfunction might help explain why women are more prone to blood vessel constriction when stressed.

If you are a heart disease patient

First, we will always advise you to see your primary care physician or cardiologist. Then, we know that physical exercise actually makes the blood vessels dilate. It does the opposite of what we see with mental stress. With that said simple techniques like:

• A guided relaxation or meditation.

• Practice regular a exercise routine, like a daily walk.

We need to find healthy ways to cope with stress, and that may be particularly important for women.

It’s not clear whether stress can cause similar blood vessel constriction in women without heart disease. The researchers also do not know whether the short-term stress reactions in these study participants could actually raise their risk of heart attack or other complications. The investigators plan to look at that in future studies.

SOURCE: The findings were published online Dec. 21 in Arteriosclerosis, Thrombosis and Vascular Biology.

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