If you have diabetes, it's critically important to work with your healthcare provider to manage your diabetes and control any other risk factors you can. Individual response to stress may be a contributing factor. Some scientists have noted a relationship between coronary heart disease risk and stress in a person's life, their health behaviors and socioeconomic status. These factors may affect established risk factors. For example, people under stress may overeat, start smoking or smoke more than they otherwise would.
Sex hormones seem to play a role in heart disease.
Several population studies show that the loss of natural estrogen as women age may contribute to a higher risk of heart disease after menopause. If menopause is caused by surgery to remove the uterus and ovaries, the risk of heart attack rises sharply. If menopause occurs naturally, the risk rises more slowly. Hormones also affect blood cholesterol. Male hormones do the opposite.