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Stress could be factor for poor MI recovery in young women
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Previous research has demonstrated disparities in recovery after MI between women and men. A new report suggests that a higher level of mental stress among women may be a factor.
Researchers examined difference in mental stress between the sexes, contributing factors to those differences, and whether the difference is linked to sex-based disparities in 1-month recovery from MI.
Xiao Xu, PhD, from the department of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine and the Center for Outcomes Research and Evaluation at Yale-New Haven Hospital, and colleagues analyzed data from 3,572 patients with acute MI (2,397 women) aged 18 to 55 years.
Xiao Xu
Women had a higher score than men on the 14-item Perceived Stress Scale (27 vs. 23.4; P < .001). The higher stress level in women was mainly explained by differences between women and men in comorbidities, physical and mental health status, intra-family conflict, caregiving demand and financial hardship, according to the researchers.
After adjustment for demographic and clinical characteristics, Xu and colleagues determined that women had worse recovery than men at 1 month after acute MI. Mean differences in improvement score ranged from –0.04 for the Euro-Qol utility index to –3.96 for angina-related quality of life (P < .05 for all). After further adjustment for baseline stress, differences in sex-based recovery were reduced, ranging from –0.03 for the Euro-Qol utility index to –3.63 for angina-related quality of life, but remained significant (P < .05 for all).
High stress at baseline was associated with worse recovery in angina-specific and overall quality-of-life metrics. The researchers also found that the effect of baseline stress did not vary between men and women.
“Helping patients develop positive attitudes and coping skills for stressful situations may not only improve their psychological well-being, but also help recovery after [acute MI],” Xu and colleagues wrote. “Given our finding that physical, mental and psychosocial factors were all associated with a patient’s stress level, stress management interventions may need to take interdisciplinary approaches (eg, targeting physical functioning, mental health and social support).”
Disclosure: Two researchers report financial ties with AstraZeneca, Bayer, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly, Medtronic, Menarini, Novartis, Sanofi, Servier and UnitedHealth.
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