Mental stress may reduce blood flow in the heart muscle of younger women with coronary heart disease, according to new research.

Coronary heart disease is the leading cause of death in American men and women, but studies show that younger women have higher rates of complications and death after a heart attack compared to men.

“Younger women tend to have quite a lot of stress in their lives,” said Viola Vaccarino, M.D., Ph.D., professor and chair of the Department of Epidemiology at Emory University in Atlanta, Georgia. “Many of them have full-time jobs and at the same time have numerous responsibilities at home, financial hardship, as well as depression and anxiety.

“Clinicians should ask about stress and emotional difficulties in these patients and recommend ways to help, such as finding time to relax and exercise.”

The study included 686 patients (191 women) 34 to 79 years old with coronary heart disease. Researchers used imaging tests to take pictures of the patients’ hearts before and during mental stress, and then examined changes in blood flow between men and women, with age as a factor.

They found stress-induced reduced blood flow happened more often in younger women compared with men and older women. It occurred in 33 percent of women age 50 or younger compared with 8 percent of men of similar ages.

Researchers also found that the difference between men and women decreased with age and disappeared in older patients. The frequency of reduced blood flow almost doubled in women compared to men for every 10-year decrease in age.

The study is published in the Journal of the American Heart Association.