Abstract
Women have been reported to be more vulnerable to the development, prognosis and mortality of cardiovascular diseases, yet the understanding of the underlying mechanisms and strategies to overcome them are still relatively undeveloped. Studies show that women’s brains are more sensitive to factors affecting mental health such as depression and stress than men’s brains. In women, poor mental health increases the risk of cardiovascular disease, and conversely, cardiovascular disease increases the incidence of mental illness such as depression. In connection with mental health and cardiovascular health, the presence of gender differences in brain activation, cortisol secretion, autonomic nervous system, vascular health and inflammatory response has been observed. This connection suggests that strategies to manage women’s mental health can contribute to preventing cardiovascular disease. Mind–body interventions, such as meditation, yoga and qigong are forms of exercise that strive to actively manage both mind and body. They can provide beneficial effects on stress reduction and mental health. They are also seen as structurally and functionally changing the brain, as well as affecting cortisol secretion, blood pressure, heart rate variability, immune reactions and reducing menopausal symptoms, thus positively affecting women’s cardiovascular health. In this review, we investigate the link between mental health, brain activation, HPA axis, autonomic nervous system, blood pressure and immune system associated with cardiovascular health in women and discuss the effects of mind–body intervention in modulating these factors.
Highlights
Women have been reported to be more vulnerable to the development, prognosis and mortality of cardiovascular diseases, yet the understanding of the underlying mechanisms and strategies to overcome them are still relatively undeveloped
In a 2015 meta-analysis study which involved 297,496 women with early menopause onset in 31 studies, early menopause onset was associated with a higher risk of overall coronary heart disease (CHD), fatal CHD, cardiovascular disease (CVD) mortality and all-cause mortality [63]
There is a gender difference in the development, prognosis and mortality of CVD, and the underlying mechanism may include a female-specific vulnerability in stress–amygdala
Summary
Accumulated research has shown more negative clinical outcomes from cardiovascular disease (CVD) in women compared to men. Epidemiological studies show that the CVD mortality rate in women exceeds that found in men [1,2,3]. In patients with acute coronary syndrome (ACS) who undergo primary percutaneous coronary intervention, the mortality rate is higher in women compared with men of similar age [4,5]. After myocardial infarction, younger women have a higher mortality rate than men of the same age or older women during hospitalization [6]. Coronary microvascular dysfunction (CMVD) which is associated with hyperactivation of the sympathetic nervous system is more frequently observed in women than in men, which increases the event-free mortality rate in women, but not in men [7,8,9]
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