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Lung Disease as a Comorbidity in 1128 Women with a Heart Condition


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Lung Disease as a Comorbidity in 1128 Women with a Heart Condition

Noreen Clark, PhD, Mary Janevic, PhD, Melissa Valerio, PhD, Laurie Lachance, PhD, Alan Baptist, MD, MPH & Georgiana Sanders, MD

American Thoracic Society International Conference
New Orleans, Louisiana
May 14-19, 2010

Center for Managing Chronic Disease
University of Michigan

Published in: Health & Medicine
  • Metabolic syndrome, a combination of fat around your abdomen, high blood pressure, high blood sugar and high triglycerides, has a greater impact on women than on men. Mental stress and depression affect women's hearts more than men's. Smoking is a greater risk factor for heart disease in women than in men. Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels.
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Lung Disease as a Comorbidity in 1128 Women with a Heart Condition

  1. 1. Lung Disease as a Comorbidity in 1128 Women with a Heart Condition At the University of Michigan Noreen Clark, PhD, Mary Janevic, PhD, Melissa Valerio, PhD, Laurie Lachance, PhD, Alan Baptist, MD, MPH & Georgiana Sanders, MD Introduction Results Results (continued) More than half of people with asthma are also managing other •The most common comorbidities with heart disease were Table 1: Mean self-rated health among women with heart disease and chronic health conditions. Among individuals age 65 to 74, arthritis (n=276; 25%) and diabetes (n=207; 18%). selected comorbidities (1=poor to 5=excellent) hypertension (51%) and heart disease (31%) are the most However, just over 9% of the women had lung disease. Of common comorbidities with asthma (1). Recent research has Disease status Mean suggested that among people with asthma, those with additional these, 4% (n-45) had been diagnosed with asthma, and Entire sample of women with heart disease 2.8 comorbidities are more likely to have asthma symptoms and another 5% (n=64) with other lung disease. Heart disease and diabetes 2.4 attacks (2). Heart disease and asthma or other lung disease 2.4 •Almost half (47%) of women with asthma considered it to Women with asthma or other lung diseases are more likely than Heart disease and arthritis 2.6 be their primary health condition, rather than heart disease. men to be simultaneously managing other conditions. Although little is known about gender-specific issues with managing multimorbidity, women have unique issues in asthma management; for example, the exacerbating role of hormonal •Among women with other lung disease, 39% considered it to be their primary health condition, rather than heart Conclusions fluctuations and body weight (3). disease. Nearly 10% of older women who participated in heart disease management education also reported lung conditions (asthma, Methods •Women with heart disease and comorbid asthma or other lung disease had significantly lower self-ratings of health (5- COPD, emphysema). Although their participation in the program suggested they perceived a need for heart-disease management Sample: 1128 women with heart disease between the ages of point scale: poor-excellent) than women with heart disease support, a substantial percentage of women with asthma and other 60-90 years (mean 72.5 years; 83% White, 15% African lung diseases actually considered these illnesses to be their main but without these conditions (2.4 vs. 2.8: p=.000). American). health problem. Previous work among women with asthma has highlighted the need for education about concurrent management All participants were community-dwelling and treated by daily Prevalence of Comorbid Conditions of other diseases or conditions that are present, as these are likely heart medication for a cardiovascular condition (i.e., arrhythmia, to complicate asthma management (4). For example, symptoms angina, myocardial infarction, congestive heart failure, or 25.0% of asthma/other lung disease and heart disease can be similar, valvular disease), as identified from patient rosters at clinics in Heart disease which can be a source of frustration for patients trying to three urban areas in Michigan, and all agreed to participate in a considered 20.0% primary health determine the appropriate medication to use (5). Findings suggest heart-disease management intervention trial. problem % that clinicians offering women disease-specific education 62% 15.0% (n=172) Other condition programs and clinical services need to consider the effect of Data collection: Telephone interviews were used to gather data 55% considered comorbidities on self-management of all conditions present, and to (n=113) on health, quality of life, and self-management behaviors. primary health devise effective ways to help women negotiate the demands of Respondents were asked about the presence of other major 10.0% problem % each. health problems besides heart disease, as well as which 38% condition they considered their primary health problem. 5.0% (n=104) 45% (n=94) 61% (n=39) 53% References (n=24) 39% 47% 1.) Asthma: The Impact of Multiple Chronic Conditions. Partnership for Solutions, Baltimore, MD, August Analysis: Using SPSS, we first calculated frequencies of the 0.0% (n=25) (n=21) 2004. most common conditions comorbid with heart disease. Next, Arthritis (N=276) Diabetes Other Lung Asthma (N=45) 2) Zhang, T., Carleton, B.C., Prosser, R.J., Smith, A.M. (2009). The added burden of comorbidity in (N=207) Disease (N=64) among women with asthma and other lung disease (e.g., patients with asthma. Journal of Asthma 46, 1021-1026. emphysema, COPD), we calculated the percentages who 3) Clark, N.M., Valerio, M.A., & Gong, Z. M. (2008). Self-regulation and women with asthma. Current Figure 1: Prevalence of common comorbidities among women with heart disease, Opinion in Allergy and Clinical Immunology 8, 222-227. reported that they considered those conditions, and not heart age 60-90 (n=1128). Includes percentage of women with each condition who think disease, to be their primary health problem. Finally, we used that it, and not heart disease, is their primary health problem. 4) Valerio, M.A., Gong, M., Wang, S., Bria, W.F., Johnson, T.R., Clark, N.M. (2009). Overweight women and management of asthma. Women’s Health Issues 19, 300-305. independent-sample t-tests to compare mean self-rated health (1=poor to 5=excellent) between women with asthma or lung 5.) Baptist, A.P., Bibban, B.K., Reddy, R.C., Nelson, B, Clark, N.M. (2010). Age-Specific Factors Influencing Asthma Management by Older Adults. Qual Health Res 20: 117-124 disease and women without those conditions.