Mental stress can double the chances of a second heart attack in some people, researchers have warned.
The study suggests mental stress could be a stronger predictor than physical stress of a repeat attack or dying of heart disease.
Researchers at Emory University in Atlanta, Georgia studied 306 people who had been treated in hospital for a heart attack in the previous eight months.
Each participant underwent two types of stress testing to examine blood flow to the heart: mental stress testing, provoked by giving a speech with emotional content in front of an intimidating, seemingly disinterested audience, and conventional stress testing.
They found that mental stress induced myocardial ischemia (reduced blood flow to the heart) occurred in 16% of patients and conventional ischemia in 35%, suggesting that traditional ischemia due to exercise or drug-induced stress is more common.
In the following three years, 10% of patients had another heart attack and two died of heart-related problems.
The incidence of heart attack or cardiovascular-related death was more than double in patients with mental-stress induced ischemia compared with those without, according to the study reported by the i.
Lead investigator Dr Viola Vaccarino said taking into account patients’ psychological stress may help clinicians better evaluate the risk of recurrent heart attacks or death seen in some patients surviving a heart attack.