Can Stress Trigger a Second Heart Attack? Yes, New Research Suggests

Female veterans suffering from post-traumatic stress disorder (PTSD) are significantly more likely to have ischemic heart disease than those without PTSD, according to a study presented at the American College of Cardiology’s Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

In this study, researchers used a nationwide Veterans Affairs (VA) database to assess health records from over 835,000 female veterans who visited any VA facility at least twice between 2000-2017. On average, the population of interest were just over 50 years old at the end of the study period, and more than 150,000 had been diagnosed with PTSD.

The results showed that women with PTSD had a 20% increased risk of having ischemic heart disease than those without PTSD. This association remained strong even when researchers accounted for a comprehensive list of factors, including age, elevated blood pressure, cholesterol, diabetes, obesity, chronic kidney disease, neuroendocrine disorders, psychiatric disorders, smoking and alcohol and illicit drug dependence.

“In our study, myocardial ischemia provoked by mental stress was a better risk indicator than what we were able to see with conventional stress testing,” lead author Viola Vaccarino, MD, PhD, Wilton Looney Professor of Cardiovascular Research in the department of epidemiology at Emory University Rollins School of Public Health in Atlanta, said a press release, adding that this is the only study of its kind in this relatively young adult population of heart attack survivors. “These data point to the important effect that psychological stress can have on the heart and on the prognosis of patients with heart disease. It gives us tangible proof of how psychological stress, which is not specifically addressed in current clinical guidelines, can actually affect outcomes.”


Vaccarino V. Mental Stress-Induced Myocardial Ischemia As a Marker for Adverse Cardiovascular Events After MI. Presented at the ACC.20 World Congress of Cardiology; March 28-30, Chicago, IL.