A traumatic event like losing a job, getting a divorce, or finding out that your spouse has cheated on you can have a negative impact on your cardiovascular and overall health. But financial woes definitely exacerbate stress significantly as well, and — particularly for women — they can increase a person’s risk of a heart attack.

According to a new study presented at the Quality of Care and Outcomes Research 2015 Scientific Sessions, a history of financial problems was linked to two times higher risk for heart attacks. Middle-aged and older women making less than $50,000 per year were more likely to have heart attacks.

The researchers based their results on 26,763 women with an average age of 56 who had participated in the national Women’s Health Study. The participants were asked questions about traumatic or negative life events — like losing a job, legal problems, long stretches of unemployment, marital issues, financial woes, death of a loved one, and serious injuries or illnesses. These women were tracked for nine years.

“Much of the prior research related to negative life events was done in persons who have a history of heart attacks and in men,” Dr. Michelle Albert, senior study author and director of the Center for the Study of Adversity and Cardiovascular Disease (NURTURE Center) at the University of California Medical Center, San Francisco, said in the press release. “It is important to assess these relationships in middle-aged and older women as this age group is more susceptible to heart disease as they age and are likely to live longer with disability.”

Indeed, lower income has been associated with poor health in the past. In a CDC report released in 2012, researchers found that educated people, who were more likely to have a higher income, were in general healthier than low-income people.

“Highly educated persons are more likely to be employed and well-paid than the less educated,” the CDC authors wrote. “They have a higher sense of control over their health and lives and more social support. In addition, the well-educated are more likely to engage in healthy behaviors and avoid unhealthy ones.”

But education doesn’t tell the whole story; even highly educated women can lose a job or find themselves in financial trouble.

“We don’t know whether women are more physiologically vulnerable as some prior research suggests that decreases in blood flow to the heart caused by acute mentally induced stress is more common in women and individuals with less social support,” Albert continued in the press release. “At the biological level, we know that adverse experiences including psychological ones can lead to increased inflammation and cortisol levels. However, the interplay between gender, heart disease, and psychological factors is poorly understood.”

Harvard Health Publications suggests that while stress and emotional issues (depression, anxiety, hostility, social isolation) can have a negative impact on your heart, there are ways to cope. Getting enough sleep, exercising, relaxing, managing your time, and nurturing yourself can all help mitigate your level of stress and thus protect your heart.

Source: Albert M, et al. Quality of Care and Outcomes Research 2015 Scientific Sessions. American Heart Association. 2015.