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Do Women With Anxiety or Depression Have Higher Rates of Myocardial Ischemia During Exercise Testing Than Men?

Paine NJ, Bacon SL, Pelletier R, Arsenault A, Diodati JG, Lavoie KL.

Circ Cardiovasc Qual Outcomes. 2016 Feb;9(2 Suppl 1):S53-61. doi: 10.1161/CIRCOUTCOMES.115.002491.

Abstract
Women diagnosed with coronary artery disease (CAD) typically experience worse outcomes relative to men, possibly through diagnosis and treatment delays. Reasons for these delays may be influenced by mood and anxiety disorders, which are more prevalent in women and have symptoms (eg, palpitations and fatigue) that may be confounded with CAD. Our study examined sex differences in the association between mood and anxiety disorders and myocardial ischemia in patients with and without a CAD history presenting for exercise stress tests. The study concluded that women with anxiety and no CAD history had higher rates of ischemia than women without anxiety. Results suggest that anxiety symptoms, many of which overlap with those of CAD, might mask CAD symptoms among women (but not men) and contribute to referral and diagnostic delays. Further research is needed to confirm this hypothesis.

Copyright © 2016 American Heart Association, Inc.View online

Keywords: anxiety; coronary artery disease; depression; ischemia; myocardial ischemia