Ten times as many women die of heart disease as breast cancer. It is the leading cause of death among women. Heart disease in women is different and it has been extensively studied. Women have heart attacks without chronic blockages on the basis of diffuse cholesterol plaques that rupture and cause a clot that blocks the artery. Men have chest pain related to fixed blockages and exertion. Women often have chest pain precipitated by stressful events, anxiety, and microvascular disease. Depressed, anxious women are more likely to have a heart attack. Women who have a heart attack are more likely to be anxious and depressed. Stress increases levels of the hormone cortisol which activates the mineralocorticoid receptor and oxidant production. That is a key part of causing hypertension and arterial disease. Treating anxiety and depression improves patient engagement with optimal medical therapy which, in turn, reduces mortality from heart artery disease by up to 90 percent. Physical health and mental health are inseperable. Family nurse practitioners do a great job of delivering optimal medical therapy. Psychiatric/mental health nurse practitioners (PMHNP) make optimal medical therapy still more effective.
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Bill, please introduce us to these NPs. You know that we can make a huge difference there, Roght? Thank you!https://www.linkedin.com/posts/joseph-thomas-shen-md-b01760106_women-with-repeated-chest-pain-and-an-update-activity-6906616984273047552-nkNz?utm_source=linkedin_share&utm_medium=member_desktop_web
Your earlier diagram and explanation of "normal coronary arteries" that are laden with cholesterol in women was outstanding and I hope people grasp the profundity of what you demonstrated. you should read post that and again from time to time