Emotional stress may trigger artery dysfunction

Woman who is stressed out and overwhelmed

Emotional stressors may be linked to artery dysfunction in some women, contributing to heart attacks and other cardiac issues.

In a recent study, researchers from the Cedars-Sinai Heart Institute set out to better understand the causes of gender-related coronary artery disease. Men with the disease typically exhibit blockages in the large arteries that are easy to detect. However, many women with the condition actually have large arteries that are clear. Instead, it’s the smaller branches connecting to capillaries that aren’t functioning properly. Researchers say it is commonly missed, leading many women with coronary artery disease to appear disease-free despite chest pain.

When the small arteries fail to work in this way, it is known as microvascular dysfunction.

For the study, researchers examined sixteen women with microvascular dysfunction and compared them to eight women of similar age and weight who did not have the disease. Investigators monitored their heart rate, blood pressure and any alterations in the time between heartbeats. This information was recorded during times of rest and again during times of mental stress. This stress was induced in a variety of ways that included performing mental arithmetic and participating in standardized tests for anger.

Both groups demonstrated similar responses, except when exposed to situations that triggered the emotional stress of anger. In women with microvascular dysfunction, this type of stress seemed to increase sympathetic nerve stimulation. This kind of nerve activity is associated with quickened heart rate. Similarly, they showed decreased parasympathetic nerve activity, which slows the heart. This suggests that the autonomic nervous system (the network of nerves that regulates heart rate) may play a part in the disease.

Researchers say that women who have chest pain and reduced oxygen to the heart, but clear large arteries, may experience microvascular dysfunction when exposed to emotional stressors even if their heart rates remain low.

“The coronary microvasculature is controlled in part by the autonomic nervous system, which includes the brain and nerves, so thoughts and emotions can impact these small vessel blood flow,” said Dr. Bairey Merz, director of the Barbra Streisand Women’s Heart Center in the Cedars-Sinai Heart Institute.

According to Merz, the study confirms this relationship and provides a mechanistic pathway to target for treatment. The next step in the research includes testing therapies to reduce angina chest pain and other cardiac issues like heart attack and stroke.

By Marianne Hayes

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