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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 Disease status Mean
common comorbidities with asthma (1). Recent research has
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
Heart disease and arthritis 2.6
Women with asthma or other lung diseases are more likely than 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 support, a substantial percentage of women with asthma and other
point scale: poor-excellent) than women with heart disease
60-90 years (mean 72.5 years; 83% White, 15% African lung diseases actually considered these illnesses to be their main
American).
but without these conditions (2.4 vs. 2.8: p=.000). health problem. Previous work among women with asthma has
highlighted the need for education about concurrent management of
All participants were community-dwelling and treated by daily other diseases or conditions that are present, as these are likely to
heart medication for a cardiovascular condition (i.e., arrhythmia, complicate asthma management (4). For example, symptoms of
angina, myocardial infarction, congestive heart failure, or valvular asthma/other lung disease and heart disease can be similar, which
disease), as identified from patient rosters at clinics in three can be a source of frustration for patients trying to determine the
urban areas in Michigan, and all agreed to participate in a heart- appropriate medication to use (5). Findings suggest that clinicians
disease management intervention trial. offering women disease-specific education programs and clinical
services need to consider the effect of comorbidities on self-
Data collection: Telephone interviews were used to gather data management of all conditions present, and to devise effective ways
on health, quality of life, and self-management behaviors. to help women negotiate the demands of each.
Respondents were asked about the presence of other major
health problems besides heart disease, as well as which
condition they considered their primary health problem. References
1.) Asthma: The Impact of Multiple Chronic Conditions. Partnership for Solutions, Baltimore, MD, August
Analysis: Using SPSS, we first calculated frequencies of the 2004. www.partnershipforsolutions.org.

most common conditions comorbid with heart disease. Next, 2) Zhang, T., Carleton, B.C., Prosser, R.J., Smith, A.M. (2009). The added burden of comorbidity in
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.