Behavioral, emotional and neurobiological determinants of coronary heart disease risk in women

• Type of Material: Article
• Authors: Viola Vaccarino, Emory University; J. Douglas Bremner, Emory University
• Language: English
• Date: 2017-03-01
• Publisher: PERGAMON-ELSEVIER SCIENCE LTD
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Elsevier Ltd
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.neubiorev.2016.04.023
• Title of Journal or Parent Work: Neuroscience and Biobehavioral Reviews
• Volume: 74
• Issue: Pt B
• Start Page: 297
• End Page: 309
• Grant/Funding Information: The work presented in this review was supported by grants from the National Institutes of Health (K24 HL077506, K24 MH076955, R01 HL68630, R01 AG026255, R21 HL093665, R01 HL109413, R01 MH056120, R01 HL088726, and P01 HL 101398) and by the National Center for Advancing Translational Sciences funded by the NIH (UL1TR000454).
• Keywords: Behavioral Sciences; REACTIVE PROTEIN-CONCENTRATION; BORDERLINE PERSONALITY-DISORDER; Science & Technology; Neurosciences; CORTICOTROPIN-RELEASING-FACTOR; ISCHEMIA SYNDROME EVALUATION; Stress; NATIONAL COMORBIDITY SURVEY; women; mental health; Neurosciences & Neurology; gender factors; POSTTRAUMATIC-STRESS-DISORDER; ACUTE MYOCARDIAL-INFARCTION; cardiovascular disease; Life Sciences & Biomedicine; MEDIAL PREFRONTAL CORTEX; DENDRITIC SPINE DENSITY; ADVERSE CHILDHOOD EXPERIENCES
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology; Health Sciences, Medicine and Surgery

Abstract

Women have more of the stress-related behavioral profile that has been linked to cardiovascular disease than men. For example, women double the rates of stress-related mental disorders such as depression and posttraumatic stress disorder (PTSD) than men, and have higher rates of exposure to adversity early in life. This profile may increase women's long-term risk of cardiometabolic conditions linked to stress, especially coronary heart disease (CHD). In addition to having a higher prevalence of psychosocial stressors, women may be more vulnerable to the adverse effects of these stressors on CHD, perhaps through altered neurobiological physiology. Emerging data suggest that young women are disproportionally susceptible to the adverse effects of stress on the risk of cardiovascular disease, both in terms of initiating the disease as well as worsening the prognosis in women who have already exhibited symptoms of the disease. Women's potential vulnerability to psychosocial stress could also help explain their higher propensity toward abnormal coronary vasomotion and microvascular disease compared with men.