Coronary Heart Disease in Women: Personality and Stress-Induced Biological Responses

Studies of reactivity to stressors have generally focused only on men. Women may react to stressors with a different adrenergic and hormonal response, however one cannot be sure that this reflects biological differences or differences in task interpretation across the sexes. Men appear to respond to behavioral stressors with a greater increase in systolic blood pressure (BP). Hemodynamic reactivity (i.e. heart rate and BP) is probably not altered by phase of menstrual cycle. Hormonal and receptor responses to stressors may well be influenced by phase of menstrual cycle; the luteal phase of the cycle may be a time of greater adrenergic responsiveness. Type A behavior and various aspects of hostility have been studied extensively as possible coronary-prone behaviors in men. However, there are very few large-scale prospective studies of such variables in women. Depressed mood has also been recognized as a potential cardiovascular risk factor, although it has received less attention than either Type A or hostility. Studies on men have reported that depression is associated with elevated cardiovascular risk even decades later, suggesting that the depression is not merely a prodrome of underlying cardiac disease. Such studies have generally not been performed on women, despite the fact that women have twice the rate of depression as men.