What About Women?
by Wayne M. Sotile, Ph.D.

At long last, the fact that heart disease is the number one health risk faced by women today is receiving the attention it deserves. The sobering fact is that more women die from cardiovascular disease each year than from all forms of cancer, combined.

But there's another story that is not receiving much-needed attention: Both as heart patients themselves and as caretakers of loved ones who have heart disease, women face coping challenges that distinguish them from men. Consider the facts. Compared to men with comparable illnesses:
· The rate of depression among women with coronary disease is at least twice as high
· Women show greater struggles with anxiety
· Women return to work later
· Women take longer to recuperate physically and have more of a sense of futility and hopelessness
· Women resume sexual activity later

Perhaps most disturbing is the fact that women heart patients receive less at-home, hands-on support and family participation in heart-healthy living than do male patients. For example, one study of 246 patients who had suffered heart attacks documented that women patients, including those who were married, received less help with meals and household tasks than men patients. And this lack of support took its toll: at one year post-MI, 20% of women died compared to 12% of men, and, when age was controlled, the risk of death was 3 times higher for married women as that observed in men.

Heart Patients Are Not the Only Women At Risk
Also at risk of coping struggles are those hordes of women who serve as caretakers for a family member who has heart disease. Some research suggests that approximately half of these caretakers get so stressed by their role, that they seek medical or psychological help. Their role sometimes proves to be impossible. Not only do they assume the role of health "police" for their sick loved one, often they assume that they must cheerlead, role-model more healthy living, run interference that keeps the patient calm, and tolerate being the target of blame when the patient has a bad day. No wonder they get stressed!

Take Charge
If you are a women heart patient, be sure that you are receiving the sort of care you deserve. Ask about referral to a cardiac rehabilitation program. Be sure not to under-report your own symptoms (as many female heart patients do). Ask for the information and support you need from your physicians and from your family members. Remember that taking appropriate care of yourself is worth being assertive about.

If you are the caretaker for a loved one with heart disease, remember that your role is complex. Give up the notion that you must do this perfectly. Also remember that this business of living with heart disease lasts a lifetime; you must pace yourself. That means taking regular breaks from caretaking, to take care of yourself. Take a lesson from the airline flight attendants who remind us daily as we travel about the country to speak to heart patients and their families: "If you are traveling with a companion, in case of emergency, first use the oxygen on yourself." The reason? You cannot be of help to another person unless you can function, yourself.

This article was adapted from information presented in Thriving With Heart Disease: A Unique Program For You and Your Family / Live Happier, Healthier, Longer. By W. Sotile (with R Cantor-Cook). The Free Press, 2003.

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