Young and middle-aged women experience more stress
than their male counterparts, which could contribute
to worse recovery from acute myocardial infarction
(AMI), according to new findings by Yale School of
Medicine researchers and their colleagues.
The findings appear in the current issue of
Circulation.
"Women tend to report greater stress and more
stressful life events than men, potentially because
of their different roles in family life and work, as
compared to men," said first author Xiao Xu,
assistant professor in the Department of Obstetrics,
Gynecology & Reproductive Sciences at Yale School of
Medicine. "This difference in the level of stress
may be an important reason for sex-based differences
in recovery after acute myocardial infarction."
Young and middle-aged women experience more stress
than their male counterparts, which could contribute
to worse recovery from acute myocardial infarction
(AMI).
Credit: Michael Helfenbein, Yale University
Xu and colleagues used data from the Variation in
Recovery: Role of Gender Outcomes on Young AMI
Patients (VIRGO) study, which is the largest
prospective observational study of young and
middle-aged women and men with AMI. VIRGO studied
AMI patients 18 to 55 years old from a large,
diverse network of 103 hospitals in the United
States, 24 in Spain and 3 in Australia from 2008 to
2012.
Xu and the team measured each patient's
self-perceived psychological stress during the
initial hospital stay for AMI using 14 questions,
which asked participants about the degree to which
their life situations during the last month were
unpredictable, uncontrollable, and overloaded.
One sample question asked, "In the last month, how
often have you been upset because of something that
happened unexpectedly?" Response to each item was
scored as never (0), almost never (1), sometimes
(2), fairly often (3), and very often (4). The team
measured each patient's recovery based on changes in
their angina-specific and overall health status
between initial hospitalization for AMI and one
month after AMI.
Compared with men, women had significantly higher
rates of diabetes, chronic lung disease, chronic
renal dysfunction, depression, and cancer, as well
as previous stents, congestive heart failure, and
stroke. Women were also more likely to have children
or grandchildren living in their household, while
experiencing greater financial strain.
"This study is distinctive in focusing particularly
on young women and going beyond traditional
predictors of risk to reveal how the context of
these people's lives influences their prognosis,"
said senior author Harlan M. Krumholz, M.D.,
principal investigator of the VIRGO study.
Xu added, "Helping patients develop positive
attitudes and coping skills for stressful situations
may not only improve their psychological well-being,
but also help recovery after AMI. Stress management
interventions that recognize and address different
sources of stress for men and women would be
beneficial.
Other authors on the study include Haikun Bao, Kelly
Strait, John A. Spertus, M.D., Judith H. Lichtman,
Gail D'Onofrio, M.D., Erica Spatz, M.D., Emily M.
Bucholz, Mary Geda, Nancy P. Lorenze, Héctor Bueno,
M.D., and John F. Beltrame.
See also
Women, heart attack and chest pain (23/02/2012)
Can You Recognize a Heart Attack or Stroke? What To
Do When Every Moment Counts (2014-10-31)
Women’s age at first menstrual cycle linked to heart
disease risk (2014-12-17)
For more information
Circulation
Sex Differences in Perceived Stress and Early
Recovery in Young and Middle-Aged Patients with
Acute Myocardial Infarction
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