Research by the University of Aston Medical School and the University of Alberta in Canada, due to be presented at an American College of Cardiology conference on Sunday (19 March), has found a link between emotional stress and heart disease in young, otherwise healthy women.
In particular, a link was found between pregnancy and spontaneous coronary artery disease (SCAD), which kills around 100 UK women every year.
The study – which was the biggest of its kind studying more than 33,000 people – monitored women over a 15 year period, a much longer time-frame than other previous studies.
Awareness of the disease is typically low, with women often failing to recognise symptoms or simply not reporting them, researchers attributed around 1,000 of the 188,000 heart attacks in the UK each year to the disease, and 70% of those affected by it were women, 30% of whom were pregnant or had recently given birth.
Dr Rahul Potluri, lead researcher and founder of the Algorithm for Comorbidities, Associations, Length of Stay and Mortality Study Unit at Aston University, said: "SCAD is unusual because, unlike other heart attacks where the coronary arteries get plugged up over time with cholesterol deposits, it's caused by a sudden tear where the coronary artery simply falls apart.
"It's also seen in a much different group of people – typically young women, many of them either pregnant or shortly after giving birth. We believe that emotional and hormonal factors play a big part in SCAD attacks, although the exact cause will vary from person to person."
SCAD is a condition which happens when one or more of the inner layers of a coronary artery tears away from the outer layer. This can prevent blood flow which can cause clots to form, in some cases leading to fatal heart attacks.
Co-researcher Dr Kevin Bainey, research interventional cardiologist at the Mazankowski Alberta Heart Institute, University of Alberta, said hoped the study would improve identification of the condition.
He said: "The key thing now is that we need to get much better at identifying SCAD so we can prevent hospitalisations and deaths. Using the big data at our disposal, we will be able to look at hundreds of different risk factors in detail to find the strongest predictors."
Men generally suffer from heart disease in greater numbers than women, meaning research has tended to focus on them as the more vulnerable group. Similarly, in clinical trials women tend to be underrepresented because it is harder to get regulatory approval for studies on women of childbearing age.
Dr Potluri told IBTimes UK he hoped the study would raise awareness of the disease, particularly in groups – such as younger women - who may not realise they were at risk. He said it was important for women to understand the symptoms of heart disease, and to speak up if they were experiencing them.