Mental Stress Has Different Effects on Heart in Men, Women

(HealthDay News) — There are clear, measurable physical differences from mental stress in men and women, according to a study published in the Journal of the American College of Cardiology.

Zainab Samad, MD, from the Duke University Medical Center in Durham, North Carolina, and colleagues analyzed data from 310 participants in the REMIT (Responses of Mental Stress-Induced Myocardial Ischemia to Escitalopram) study with stable ischemic heart disease.

Participants underwent psychometric assessments, transthoracic echocardiography, and platelet aggregation studies at baseline and after three mental stress tasks.

The development or worsening of regional wall motion abnormality, reduction of left ventricular ejection fraction (LVEF) ≥8% by transthoracic echocardiography, and/or ischemic ST-segment change on electrocardiogram during at least one mental stress task characterized mental stress-induced myocardial ischemia (MSIMI).

At baseline, women had higher depression and anxiety (P<.05), the researchers found. Compared with men, women at rest had heightened platelet aggregation responses to serotonin (P=.007) and epinephrine (P=.004).

Women had more MSIMI (P<.04), expressed more negative (P=.02) and less positive emotion (P<.001), and demonstrated higher collagen-stimulated platelet aggregation responses (P=.04) than men, following mental stress.

Compared with women, though, men were more likely to show changes in traditional physiological measures such as blood pressure (P<.05).

“Further studies should test the association of sex differences in cardiovascular and platelet reactivity in response to mental stress and long-term outcomes,” the researchers wrote.


  1. Samad Z et al. J Am Coll Cardiol. 2014;64(16):1669-1678.