Psychological factors and atherosclerotic cardiovascular disease development in women: A narrative review

Cardiovascular disease (CVD) is the leading cause of mortality, with rising evidence of differences between women and men, worldwide. Data from the literature indicate the presence of gender-specific differences both in biological responses and in lifestyle behaviors to psychological stress. There is evidence suggesting that women experience higher levels of psychological problems, such as anxiety and depression. The connection between psychological factors and CVD can be explained by behavioral and biological risk factors, as well as underlying mechanisms, such as the sympathetic nervous system overactivity and the hypothalamic-pituitary-adrenal function impairment. Moreover, some psychosocial factors may place women at particular risk of CVDs. Given these hypotheses, the present review summarizes the existing knowledge about psychological factors and CVD connection in women, highlighting the sex differences.