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Heart Disease in Women

Published online by Cambridge University Press:  07 November 2014

Extract

Coronary heart disease (CHD) remains the leading cause of death in women in the United States and other industrial countries. CHD accounts for 250,000 female deaths per year, and in contrast to men, there is no indication of declining death rates. Women <65 years of age are twice as likely to die from myocardial infarction (MI) as men and have a poorer prognosis if they survive. Nevertheless, CHD has long been considered a “male” disease and many of the guidelines for prevention, diagnosis, and treatment of CHD are extrapolated from data of predominantly middle-aged men to women. It was only in the early 1990s that the National Institute of Health required that researchers report outcome analyses separately by sex. Since then, data has emerged showing that the magnitude of risk conferred by traditional risk factors for CHD (eg, hypertension, diabetes, and smoking) differs between men and women. Sex differences in molecular and cellular mechanisms, and genetics as well as responses to treatment are still vastly understudied.

Increasing evidence suggests that besides traditional CHD risk factors, negative emotions are independent prognostic risk factors for CHD. Recently published guidelines by an expert panel for cardiovascular disease prevention in women mention depression as a target for potential psychosocial interventions. Anxiety has also been shown to predict CHD incidence, acute coronary syndromes (ACS), morbidity and mortality post-ACS, and sudden cardiac death. Studies on the relationship between anxiety and CHD have shown mixed results.

Type
Symposium Monograph Supplement
Copyright
Copyright © Cambridge University Press 2004

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References

1. Hochman, JS, McCabe, CH, Stone, PH et al. Outcome and profile of women and men presenting with acute coronary syndromes: a report from TIMI IIIB. J Am Coll Cardiol. 1997;3(1):141148.CrossRefGoogle Scholar
2. Harris, DJ, Douglas, PS. Enrollment of women in cardiovascular clinical trials funded by the National Heart, Lung, and Blood Institute. N Engl J Med. 2000;343(7):475480.CrossRefGoogle ScholarPubMed
3. Wenger, NK. You've come a long way, baby: cardiovascular health and disease in women: problems andprospects. Cinulatim. 2004;109(5):558560.Google Scholar
4. Rozanski, A, Blumenthal, JA, Kaplan, J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999;99:21922217.CrossRefGoogle ScholarPubMed
5. Mosca, L, Appel, LJ, Benjamin, EJ, et al. Evidence-based guidelines for cardiovascular disease prevention in women. Arterioscler Thrtmb Vase Biol. 2004;24(3):2950.Google ScholarPubMed
6. Kubzansky, LD, Kawachi, I, Weiss, ST, Sparrow, D. Anxiety and coronary heart disease: a synthesis of epidemiological, psychological, and experimental evidence. Ann Behav Med. 1998;20(2):4758.CrossRefGoogle ScholarPubMed
7. Strik, JJ, Denollet, J, Lousberg, R, Honig, A. Comparing symptoms of depression and anxiety as predictors of cardiac evenrs and increased health care consumption after myo-cardial infarction. J Am Cell Cardiol. 2003;42(10):18011807.CrossRefGoogle Scholar
8. Kawachi, I, Sparrow, D, Vokonas, PS, Weiss, ST. Symptoms of anxiety and risk of coronary heart disease. The Normative Aging Study. Circulation. 1994;90(5):22252229.CrossRefGoogle ScholarPubMed
9. Kawachi, I, Colditz, GA, Ascherio, A, et al. Prospective study of phobic anxiety and risk of coronary heart disease in men. Circulation. 1994;89(5):19921997.CrossRefGoogle ScholarPubMed
10. Fleet, RP, Beitman, BD. Cardiovascular death from panic disorder and panic-like anxiety: A critical review of the literature. J Psychosm Res. 1998;44(1):7180.CrossRefGoogle ScholarPubMed
11. Todaro, JF, Shen, BJ, Niaura, R, Spiro, A3rd, Ward, KD. Effect of negative emotions on frequency of coronary heart disease (The Normative Aging Study). Am J Cardiol. 2003;92(8):901906.CrossRefGoogle ScholarPubMed
12. Eaker, ED, Pinsky, J, Castelli, WP. Myocardial infarction and coronary death among women: psychosocial predictors from a 20-year follow-up of women in the Framingham Study. Am J Epidemiol. 1992;135(8):854864.CrossRefGoogle ScholarPubMed
13. Haines, AP, Imeson, JD, Meade, TW. Phobic anxiety and ischaemic heart disease. Br Med J (Clin Res Ed). 1987;295(6593):297299.CrossRefGoogle ScholarPubMed
14. Haines, A, Cooper, J, Meade, TW. Psychological characteristics and fatal ischaemic heart disease. Heart. 2001;85(4):385389.CrossRefGoogle ScholarPubMed
15. Coryell, W, Noyes, R, Clancy, J. Excess mortality in panic disorder. A comparison with primary unipolar depression. Arch Gen Psychiatry. 1982;39(6):701703.CrossRefGoogle ScholarPubMed
16. Coryell, W, Noyes, R Jr., House, JD. Mortality among outpatients with anxiety disorders. Am J Psychiatry. 1986;143(4):508510.Google ScholarPubMed
17. Markovitz, JH, Matthews, KA, Wing, RR, Kuller, LH, Meilahn, EN. Psychological, biological and health behavior predictors of blood pressure changes in middle-aged women. J Hypertens. 1991;9(5):399406.CrossRefGoogle ScholarPubMed
18. Markovitz, JH, Matthews, KA, Kannel, WB, Cobb, JL, D'Agostino, RB. Psychological predictors of hypertension in the Framingham Study. Is there tension in hypertension? JAMA. 1993;270(20):24392443.CrossRefGoogle Scholar
19. Papakostas, GI, Ongur, D, Iosifescu, DV, Mischoulon, D, Fava, M. Cholesterol in mood and anxiety disorders: review of the literature and new hypotheses. Eur Neuropsychopbarmacol. 2004;14(2):135142.CrossRefGoogle ScholarPubMed
20. Curtis, BM, O'Keefe, JH Jr., Autonomic cone as a cardiovascular risk factor: the dangers of chronic fight or flight. Mayo Clin Proc. 2002;77(1):4554.CrossRefGoogle ScholarPubMed
21. Watkins, LL, Grossman, P, Krishnan, R, Sherwood, A. Anxiety and vagal control of heart rate. Psychosom Med. 1998;60(4):498502.CrossRefGoogle ScholarPubMed
22. Dekker, JM, Crow, RS, Folsom, AR, et al. Low heart rate variability in a 2-minute rhythm strip predicts risk of coronary heart disease and mortality from several causes: the ARIC Study. Atherosclerosis risk in communities. Circulation. 2000;102(11):12391244.CrossRefGoogle Scholar
23. Yeragani, VK, Mallavarapu, M, Radhakrishna, RK, et al. Linear and nonlinear measures of blood pressure variability: increased chaos of blood pressure time series in patients with panic disorder. Depress Anxiety. 2004;19(2):8595.CrossRefGoogle ScholarPubMed
24. Gidron, Y, Gilutz, H, Betger, R, Huleihel, M. Molecular and cellular interface between behavior and acute coronary syndromes. Cardiovasc Res. 2002;56(1): 1521.CrossRefGoogle ScholarPubMed
25. Kuper, H, Marmot, M, Hemingway, H. Systematic review of prospective cohort studies of psychosocial factors in the aetiology and prognosis of coronary heart disease. Semin Vase Med. 2002;2:267314.CrossRefGoogle ScholarPubMed
26. Rugulies, R. Depression as a predictor for coronary heart disease, a review and meta-analysis. Am J Prev Med. 2002;23(1):5161.Google ScholarPubMed
27. Kubzansky, LD, Kawachi, I. Going to the heart of the matter: do negative emotions cause coronary heart disease? J Psychosom Res. 2000;48(4–5):323337.CrossRefGoogle Scholar