Public Release: 

Unique role of gender is featured in Circulation journal's Go Red For Women issue focused on women's heart health

American Heart Association

DALLAS, Feb. 19, 2018 -- Mental stress was more likely to cause chest pain in young women who have had a heart attack compared to a comparable group of men, according to a study published in a special issue of Circulation, a journal of the American Heart Association that also includes an additional 10 original studies and research letters about the unique role gender plays in heart health.

This is the second Go Red For Women issue of Circulation, celebrating the Association's focus on women during the month of February. It includes studies about heart disease linked to pregnancy, spontaneous preterm delivery, pre-eclampsia, mental stress, risk factors, stroke and other topics.

"In the United States, 1 in 4 women die from heart disease, yet the vast majority of women remain unaware that the single greatest risk to their health and longevity is heart disease," said Joseph Hill, M.D., Ph.D., editor-in-chief of Circulation and professor of medicine and molecular biology at U.T. Southwestern in Dallas, Texas. "With this issue we shine a bright light on some of the best science emerging in the domain of women's cardiovascular health," he said.

Editorial by Sharon C. Reimold, M.D. and Joseph A. Hill, M.D., Ph.D.

  • Joseph A. Hill, M.D., Ph.D., editor-in-chief of Circulation; professor of medicine and molecular biology and chief of cardiology at UT Southwestern Medical Center, Dallas, Texas
  • After Feb. 19, view editorial online

Highlighted studies include:

Mental stress Induced-myocardial ischemia in young patients with recent myocardial infarction: sex differences and mechanisms

Myocardial ischemia is defined as inadequate blood flow to the heart muscle due to reduction in blood flow to the heart, which can be caused by blockages (plaque) in the major coronary arteries or by microvascular dysfunction, which means dysfunction of the small arteries leading to the heart.

This study included 306 patients (150 women and 156 men) under 61 years of age who were hospitalized for heart attacks in the previous 8 months and 112 community controls (58 women and 54 men) matched for sex and age to the heart attack patients.

The researchers measured how well the participants' blood vessels functioned at rest and 30 minutes after mental stress caused by a public speaking task. They found that young female heart attack survivors had twice the risk of experiencing myocardial ischemia induced by mental stress.

  • Viola Vaccarino, M.D., Ph.D., professor of medicine, Rollins School of Public Health, Emory University, Atlanta, Georgia
  • After Feb. 19, view the manuscript online

Sex differences in the presentation and perception of symptoms among young patients with myocardial infarction: evidence from the VIRGO study

Some studies report that women are less likely to have chest pain during a heart attack. For this study, researchers interviewed 2,009 women and 976 men aged 18-55 hospitalized for heart attacks regarding symptoms they experienced during their heart attack.

Approximately 90 percent of both women and men experienced chest pain (defined as pain, pressure, tightness or discomfort) during their heart attack. However, women were more likely to report additional symptoms compared to men, such as nausea, palpitations and pain or discomfort in the jaw, neck, arms or between the shoulder blades.

Approximately 29.5 percent of women and 22.1 percent of men sought medical care for similar symptoms before their hospitalization, but 53 percent of the women reported that their healthcare provider did not think these symptoms were heart related as compared with 37 percent of men.

  • Judith Lichtman, M.D., associate professor, Yale School of Public Health, New Haven, Connecticut
  • After Feb. 19, view the manuscript online

Additional original articles and research letters that appear in the second Go Red For Women issue of Circulation are available to the public and include:

Female sex is a risk modifier rather than a risk factor for stroke in atrial fibrillation: Should we use a CHA2DS2-VA score rather than CHA2DS2-VASc?

  • Peter Brønnum Nielsen, Ph.D., professor, Aalborg University Hospital, Skovvej, Denmark
  • After Feb. 19, view the manuscript online

Metabolic predictors of incident coronary heart disease in women

  • Nina P. Paynter, Ph.D, assistant professor of medicine, Harvard Medical School, Boston, Massachusetts
  • After Feb. 19, view the manuscript online

Sex difference in patients with ischemic heart failure undergoing surgical revascularization: results from the STICH trial

  • lleana L. Piña, M.D.; M.P.H., professor of medicine, epidemiology and population health, Albert Einstein College of Medicine, New York, New York
  • After Feb. 19, view the manuscript online

Pregnancy outcome in women with rheumatic mitral valve disease: Results from the registry of pregnancy and cardiac disease (ROPAC)

  • J.W. Roos-Hesselink, M.D, Ph.D., professor of adult congenital cardiology, The Erasmus University Medical Center, Rotterdam, The Netherlands
  • After Feb. 19, view the manuscript online

Myocardial scar is prevalent and associated with subclinical myocardial dysfunction in women with suspected ischemia but no obstructive coronary artery disease: From the women's ischemia syndrome evaluation - coronary vascular dysfunction study

  • Janet Wei, M.D., assistant professor of medicine and biomedical sciences, Cedars-Sinai Heart Institute, Los Angeles, California
  • After Feb. 19, view the manuscript online

Genetics, lifestyle, and LDL cholesterol in young and apparently healthy women

  • Jan Albert Kuivenhoven, associate professor, University Medical Center, Groningen, University of Groningen, The Netherlands
  • After Feb. 19, view the manuscript online

Prevalence of subclinical coronary artery disease assessed by coronary computed tomography angiography among women with a history of preeclampsia aged 45 to 55 years

  • Gerbrand A. Zoet, M.D., Ph.D., University Medical Center Utrecht, The Netherlands
  • After Feb. 19, view the manuscript online

Long-term analysis of sex differences in prestigious authorships in cardiovascular research supported by the NIH

  • Carolin Lerchenmüller, M.D.; Harvard University School of Medicine, Boston, Massachusetts
  • After Feb. 19, view the manuscript online

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Additional Resources:

  • Go Red For Women
  • Follow AHA/ASA news on Twitter @HeartNews
  • For updates and new science from the Circulation journal follow @CircAHA

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at http://www.heart.org/corporatefunding.

About the American Heart Association

The American Heart Association is devoted to saving people from heart disease and stroke - the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation's oldest and largest voluntary organization dedicated to fighting heart disease and stroke. To learn more or to get involved, call 1-800-AHA-USA1, visit heart.org or call any of our offices around the country. Follow us on Facebook and Twitter.

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