Young and middle-aged women who recently survived a myocardial infarction have more parasympathetic withdrawal than men in daily life, especially during moments of negative mood.
Women who survived an MI in midlife reported higher levels of negative mood and stress than men across a week of real-life monitoring.
Women had significantly lower parasympathetic activity than men in daily life, measured by daily average deceleration capacity.
Heart rate variability was also lower in women than in men.
Daily negative mood was associated with lower deceleration capacity in women but not in men.
Adjustment for other risk factors did not materially change the mood–autonomic associations.
The authors conclude that women need greater attention to psychosocial management after MI.
This study followed 302 people aged 61 or younger who had recently been hospitalized for a heart attack. For one week at home, participants reported their mood and stress levels several times through brief check-ins, while wearing a heart monitor that recorded how their nervous system was regulating the heart. The researchers focused on the parasympathetic (calming, 'rest and digest') part of the nervous system, which helps protect the heart. Women reported more negative mood and stress than men. They also showed lower parasympathetic activity and lower heart rate variability, both signs of less healthy autonomic regulation. On days when women felt more negative, their parasympathetic activity dropped by about 4.5% for each unit increase in negative mood. In men the change was close to zero (0.5%). These patterns held after accounting for other risk factors. This research suggests that emotional stress may affect the heart's nervous system control differently in women than in men after a heart attack. This could help explain why younger women tend to do worse after a heart attack despite having less blockage in their arteries. The findings point to the potential value of attention to psychological well-being in women after a heart attack. The study measured associations only, so it cannot show that mood directly causes these physiological changes.
Vaccarino V, She H, Elon L, Lewis T, Ko Y, Clifford G, et al.. (2026). Real-Life Psychological Experiences and Cardiac Autonomic Physiology Among Survivors of a Myocardial Infarction in Midlife.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.126.052187