HealthDay News — There are clear, measurable physical differences from mental stress in men and women, according to a study published in the Journal of the American College of Cardiology.

“Although emotional stress is associated with ischemic heart disease (IHD) and related clinical events, sex-specific differences in the psychobiological response to mental stress have not been clearly identified,” explained Zainab Samad, MD, of the Duke University Medical Center in Durham, N.C., and colleagues.

To study the differential psychological and cardiovascular responses to mental health stress between male and female patients with stable IHD, the researchers followed 310 participants in the REMIT (Responses of Mental Stress-Induced Myocardial Ischemia to Escitalopram) study with stable IHD.

Continue Reading

Participants underwent psychometric assessments, transthoracic echocardiography, and platelet aggregation studies at baseline and after three mental stress tasks. The development or worsening of regional wall motion abnormality, reduction of left ventricular ejection fraction (LVEF) ≥8 percent by transthoracic echocardiography, and/or ischemic ST-segment change on electrocardiogram during at least one mental stress task characterized mental stress-induced myocardial ischemia (MSIMI).

At baseline, women had higher depression and anxiety (P<0.05). Compared with men, women at rest had heightened platelet aggregation responses to serotonin (P=0.007) and epinephrine (P=0.004).

Women had more MSIMI (P<0.04), expressed more negative (P=0.02) and less positive emotion (P<0.001), and demonstrated higher collagen-stimulated platelet aggregation responses (P=0.04) than men, following mental stress. Compared with women, though, men were more likely to show changes in traditional physiological measures such as blood pressure (P<0.05).

“Further studies should test the association of sex differences in cardiovascular and platelet reactivity in response to mental stress and long-term outcomes,” concluded the scientists.


  1. Samad Z et al. J Am Coll Cardiol. 2014; doi: 10.1016/j.jacc.2014.04.087