Although many of them don't know it, women with heart disease make up the largest health risk group in the United States. Heart disease is by far the biggest killer in America, and women are 15 percent more likely to die of it than men, according to the American Heart Association.
Because of advances in treatment and diagnosis for men, the number of them dying from heart disease annually has dropped from 510,000 two decades ago to 440,000 today. But in that same period, the number of women dying each year from the disease has risen from 490,000 to 510,000, the association says.
This survey, published in the current edition of Women's Health Issues, puts a human face on that disparity in care, says study co-author Dr. Sharonne Hayes, director of the women's heart clinic at the Mayo Clinic in Rochester, Minn.
"We wanted to know how heart disease changed these women's lives," she says. "As a physician, I see how it affects them, but this lets us hear in their own voices that it often changes every aspect of their lives."
The survey questioned 204 women heart patients from around the country. It is unique because it asked open-ended questions and focused on how the disease influenced the quality of life for afflicted women. It was funded by a group called WomenHeart: The National Coalition for Women With Heart Disease.
"By having open-ended questions, it obviously make this survey more work, but it also gave us the breadth of their experience," Hayes says. "We allowed women to really tell things as they were."
The findings include:
- 52 percent of the respondents were dissatisfied with some aspect of their care;
- 58 percent of them attributed the problem to physician attitudes and communication styles;
- 57 percent said they suffered some mental illness from the disease, ranging from anxiety (17 percent) to clinical depression (38 percent), or both (21 percent);
- 27 percent said relationships with their families deteriorated as a result of the illness;
- just 35 percent of patients said they recognized their heart disease symptoms early on, while 45 percent felt the disease "came out of the blue";
- and 42 percent of women said they had to change their work schedule or leave job as a result of the illness.
"This should be a wake-up call for those of us who care for women with heart disease," Hayes says. "We still identify heart disease with middle-age men. But we need to make the right diagnosis for women early on. We need to think 'heart' in doctors' offices and emergency rooms."
The study cites a 1999 Gallup poll, in which only 55 percent of primary-care physicians correctly identified heart disease as the greatest risk to women over 50.
In the general population, women are three times more likely to be depressed than men. But when depression occurs among heart patients, it increases the risk they will die early because they are less likely to take care of themselves, says Dr. Nieca Goldberg, chief of the women's heart program at Lenox Hill Hospital in New York City and author of Women are Not Small Men: Lifesaving Strategies for Preventing and Healing Heart Disease in Women.
"The connection between mind and body can't be written off," she says. "We have some pretty good statistics that show that the blood-clotting cells have increased clumping activity during depression. That could lead to more heart attacks."
Goldberg adds, "We're so good at whipping people into the hospital and doing these high-tech treatments, but sometimes we need to look past that and make sure we improve the quality of life for these people as well. It's a long-term process."
For facts about heart disease and women, visit WomenHeart: The National Coalition for Women With Heart Disease. Or for information about preventing heart disease, try the U.S. Centers for Disease Control and Prevention.