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Do Men and Women Differ on Measures of Mental Stress-Induced Ischemia?

From Cardiovascular Research (K.M.Y., M.H., D.L., M.B., D.S.S.), Department of Medicine, University of Florida, Gainesville, Florida; North Florida/South Georgia VA Healthcare System (K.M.Y., M.H., D.L., M.B., D.S.S.), Gainesville, Florida; Department of Biostatistics (Q.L., H.L.), University of Florida, Gainesville, Florida; and Department of Community Dentistry and Behavioral Science (R.B.F.), College of Dentistry, University of Florida, Gainesville, Florida.

Address correspondence and reprint requests to Kaki M. York, PhD, Psychology Service (116B), 1601 SW Archer Rd, Gainesville, FL 32608. E-mail: kaki.york{at}va.gov

Objective: To consider the effects of gender on ischemia in a larger sample, with broadly defined coronary artery disease (CAD). Mental stress has been shown to cause transient myocardial ischemia in a significant percentage of people with CAD. However, little is known about the effects of mental stress on ischemic processes in women. Most studies to date either had few women or required a positive exercise stress test.

Methods: Participants (61 women, 93 men; average age = 63 years) had documented CAD (positive stress test, abnormal catheterization even with minimal disease, or previous myocardial infarction). They underwent mental stress testing and radionuclide perfusion imaging (stress/ rest). Cardiac function data were collected and stress was compared with baseline. The data were then submitted to a series of analyses of variance.

Results: A total of 50 (32%) participants exhibited reversible ischemia post psychological stress. This reflects a relative rate of 33% (n = 31of 93) for men and 31% (n = 19 of 61) for women. No difference between men and women were observed on any measure of hemodynamic functioning (blood pressure, heart rate, or cardiac perfusion).

Conclusions: Results of this study showed no significant differences between men and women on measures of hemodynamic functioning or cardiac perfusion.

Key Words: gender • mental stress • myocardial ischemia • hemodynamic • single photon emission computed tomography

Abbreviations: ACE = angiotensin-converting enzyme; BMI = body mass index; CABG = coronary artery bypass graft; CAD = coronary artery disease; DBP = diastolic blood pressure; DBP = change in diastolic blood pressure; LVEF = left ventricular ejection fraction; HR = heart rate; HR = change in heart rate; MI = myocardial infarction; SBP = systolic blood pressure; SBP = change in systolic blood pressure; SDS = summed difference score; VAMS = Visual Analogue Mood Scale.