Women who report high levels of psychosocial stress, such as from caregiving and lack of emotional support, show signs of early heart tissue changes associated with cardiovascular disease - an association not observed in men, a new study reveals.
The results support the notion that there are sex-specific ways in which stress affects cardiovascular health and that risk-assessment processes should take psychosocial factors and mental wellness into account, the researchers said.
"From an epidemiological point of view, we have known for about two decades that stress is an important risk factor in cardiovascular health for people born female. But with this research stream, we're really aiming to understand how stress physiologically impacts the heart," said Dr. Judy Luu, Assistant Professor at the Division of Clinical and Translational Research at the McGill Faculty of Medicine and principal investigator of the study.
The team, comprising researchers from McGill and Concordia universities, published a paper earlier this year linking early signs of heart inflammation and perceived social status in women.
MRI scans reveal signs of inflammation
In the current study, the researchers examined MRI heart scans of 219 adult participants (ages 43 to 65), around half of whom were female. The scans measured two markers (called T1 and T2) in the heart muscles, which are linked to signs of cardiac disease. In addition to demographic and basic physiological data, they also collected information such as perceived stress, responsibility for caregiving within the household and perceived emotional support.
The participants, who were part of the Courtois Cardiovascular Signature Program at McGill University Health Centre, were divided in two groups: individuals presenting at least one risk factor for cardiovascular disease (for example, diabetes, hypertension or smoking) but without actual heart disease, and healthy control subjects.
In both groups, the scans of female participants who reported high psychosocial stress revealed significantly higher values for one of the markers (T1) than did the scans of low-stress female participants. A significant difference in female participants was also observed for the second marker (T2), in the at-risk group only. In both cases, no significant difference was observed between high- and low-stress male participants.
Though the T1 and T2 values didn't quite pass the clinical thresholds for abnormal values, said Luu, they were still at an elevated level that calls for further investigation. She added that down the road, higher values portend worse prognosis.
Biological roots
According to the professor, the sex differences observed are not only a social question, but also a biological question.
"Research points to the fact that there are biological differences in the way females physically handle stress," said Luu.
The next phase of the research will focus on blood markers and other biological explanations, such as hormones, she said, adding that the team hopes the research can lead to better interventions to advance women's heart health.
The study
"Sex Differences in the Relationship Between Psychosocial Stress and Myocardial Tissue Characteristics: A CMR Imaging Study" by Mayssa Moukarzel and al. was published in Circulation: Cardiovascular Imaging.
The research was supported by the Courtois Cardiovascular Signature Program through the McGill University Health Centre Foundation.
