Psychological factors and atherosclerotic cardiovascular disease development in women: A narrative review

Abstract

Cardiovascular disease (CVD) is the leading cause of mortality, with rising evidence of differences between women and men, worldwide. Data from the literature indicate the presence of gender-specific differences both in biological responses and in lifestyle behaviors to psychological stress. There is evidence suggesting that women experience higher levels of psychological problems, such as anxiety and depression. The connection between psychological factors and CVD can be explained by behavioral and biological risk factors, as well as underlying mechanisms, such as the sympathetic nervous system overactivity and the hypothalamic-pituitary-adrenal function impairment. Moreover, some psychosocial factors may place women at particular risk of CVDs. Given these hypotheses, the present review summarizes the existing knowledge about psychological factors and CVD connection in women, highlighting the sex differences.

Gender specifics of affective disorders in patients with coronary heart diseas (according to screening and psychometric tests)

“…Vlachopoulou и соавт. подчеркивают, что во всем мире растет число свидетельств различий в течении и исходах ССЗ между мужчинами и женщинами [15]. J. C. McSweeney и соавт.…”

“…Психологические стрессовые расстройства в 2 раза чаще встречаются у женщин с ишемической болезнью сердца по сравнению с мужчинами [17]. Кроме того, некоторые психосоциальные факторы могут подвергать женщин особому риску развития ССЗ [15]. Уязвимость женщин к психосоциальному стрессу, наличие симптомов депрессии могут помочь объяснить их более высокую склонность к аномальной коронарной вазомоторной функции и микрососудистым заболеваниям по сравнению с мужчинами [18].…”

The heart-mind relationship in women cardiovascular primary prevention: the role of depression, anxiety, distress and Type-D personality in the 10-years cardiovascular risk evaluation

“…Nonetheless, psychological symptoms and disorders, including depression, anxiety and distress, which are acknowledged risk factors for CVD ( 3 – 9 ), are more often detected in women than men ( 10 , 11 ). According to the narrative review by Vlachopoulou et al ( 12 ), depression in women is strongly linked to CVD. Depression is known to be a risk factor for fatal coronary heart disease (CHD) in women who have no baseline CHD, and a high risk for CHD in women with both Type 1 and Type 2 diabetes.…”

“…Depression is known to be a risk factor for fatal coronary heart disease (CHD) in women who have no baseline CHD, and a high risk for CHD in women with both Type 1 and Type 2 diabetes. Additionally, depression is independently predictive of coronary artery disease (CAD) in women, along with hypertension, waist-hip ratio and physical inactivity ( 12 ). The authors emphasized the role of anxiety, observing that women with high levels of phobic anxiety face a greater risk of fatal CHD, and that CVD events can be predicted in women with suspected myocardial ischemia who exhibit comorbid depression and anxiety symptoms ( 12 ).…”

“…Additionally, depression is independently predictive of coronary artery disease (CAD) in women, along with hypertension, waist-hip ratio and physical inactivity ( 12 ). The authors emphasized the role of anxiety, observing that women with high levels of phobic anxiety face a greater risk of fatal CHD, and that CVD events can be predicted in women with suspected myocardial ischemia who exhibit comorbid depression and anxiety symptoms ( 12 ). There is a wide and compelling evidence linking psychological distress with earlier onset of CVD, faster disease progression, worse prognosis, and an increased risk of mortality ( 13 – 17 ).…”