The Bidirectionality of Psychosocial Stress and Cardiovascular Disease Risk in Women; Recognition and Strategies for Management.

Purpose of review: This review describes and summarizes the relationships between psychosocial stress and cardiovascular disease risk in women and offers strategies and recommendations to improve health outcomes.

Recent findings: Psychosocial stress plays a pivotal role in the cardiovascular health of women, acting both as a precipitant and an outcome of CVD. As a precipitant, chronic stressors such as caregiving responsibilities, socioeconomic adversity, intimate partner violence, and gendered barriers to healthcare can exacerbate stress-related CVD risk factors which in turn predispose to upregulation of inflammatory factors. Mental health conditions (anxiety, depression, and post-traumatic stress disorder) are more prevalent in women and further contribute to cardiovascular risk through sex-specific mechanisms mediated by dysregulation of the hypothalamic-pituitary-adrenal axis and associated autonomic nervous system dysfunction. Conversely, women with CVD may experience psychosocial stress, with higher levels of anxiety, depression, and fear of recurrence, which negatively affects recovery and long-term health outcomes. Psychosocial stress plays a pivotal role in the cardiovascular health of women, acting both as a precipitant and an outcome of CVD. This bidirectional relationship highlights the need for integrated, sex- and gender-based approaches to cardiovascular care that address both physical and psychosocial stressors, improving outcomes and quality of life for women at risk or living with CVD.