The death of a loved one or a life-threatening illness can put people under a lot of emotional strain, but a new study suggests that, for women, the health implications could be even graver. Researchers state that traumatic life events could increase the risk of heart attack by more than 65% in middle-aged and older women.
Heart disease is the cause of 1 in every 4 female deaths.

Independent of this increase in risk, the researchers also found that a history of financial struggle was associated with two times the risk of heart attack in middle-aged and older women. Their findings suggest that women whose households earn less than $50,000 a year - above the federal poverty threshold - may be more vulnerable to attack too.

"Much of the prior research related to negative life events was done in persons who have a history of heart attacks and in men," explains senior study author Dr. Michelle A. Albert, director of the Center for the Study of Adversity and Cardiovascular Disease at the University of California Medical Center, San Francisco.

"It is important to assess these relationships in middle-aged and older women as this age group is more susceptible to heart disease as they age and are likely to live longer with disability."

Dr. Albert will be presenting the study's findings at the Quality of Care and Outcomes Research 2015 Scientific Sessions. The study was funded by the National Institutes of Health/National Institute of Aging.

Although events that cause psychological stress are known to predict adverse health outcomes and increase the risk of cardiovascular events such as heart attacks, the researchers set out to assess specifically what types of stress significantly affect the hearts of middle-aged and older women.

Despite some people considering heart disease to be a "man's disease," heart disease kills approximately the same number of men and women in the US each year. Heart disease is the leading cause of death for women in the country, yet according to the Centers for Disease Control and Prevention (CDC), only 54% of women recognize it as such.

'Interplay between gender, heart disease and psychological factors is poorly understood'

To specifically assess the impact of different stressors on heart health, the researchers analyzed data from 26,763 women with an average age of 56 who participated in the Women's Health Study. The participants were followed for an average of 9 years to assess their risk of heart attack.

Each participant completed a questionnaire comprised of questions about negative life events - the death of a loved one, serious financial problems and unemployment, for example - and lifetime traumatic events such as developing a life-threatening illness and being the victim of a serious assault.

The researchers compared women who had suffered heart attacks with women who had not, and then compared 267 women who had a history of heart attack with 281 age-matched women who smoked.

"In this analysis among middle-aged and older women, we found supportive evidence that negative cumulative life events were associated with [heart attack] risk, especially in low-income women and those suffering major traumatic life events," the authors state.

Even after adjusting for heart disease risk factors and socioeconomic status, the researchers found that the risk of heart attack was increased by traumatic life events.

"We don't know whether women are more physiologically vulnerable, as some prior research suggests that decreases in blood flow to the heart caused by acute mentally-induced stress are more common in women and individuals with less social support," admits Dr. Albert.

"At the biological level, we know that adverse experiences including psychological ones can lead to increased inflammation and cortisol levels. However, the interplay between gender, heart disease and psychological factors is poorly understood."

The researchers conclude that further research is warranted and, in particular, among women with limited socioeconomic resources.

Medical News Today previously reported on a study suggesting that women who have been divorced may be at a significantly higher risk of heart attack, with the risk appearing to increase with multiple divorces.

Written by James McIntosh