Gender and perceived severity of cardiac disease: evidence that women are "tougher".
OBJECTIVE
Patients' beliefs about their disease may affect their willingness to engage in preventive health behaviors. We sought to determine whether men and women with acute coronary syndrome differ in their perceptions of the severity of cardiac-related illness while controlling for the clinical severity of their condition.


METHODS
All patients with acute coronary syndrome discharged from a university hospital during a 3-year period were mailed a questionnaire, and medical records were abstracted. The questionnaire assessed perceived severity of cardiac-related illness (5-point scale from "very mild" to "very severe"), symptom frequency, type of acute coronary syndrome event, number of medications, Duke Activity Status Index (DASI), time since most recent cardiac event, Charlson Comorbidity Index, and demographic information. A logistic regression model was constructed with perceived severity of heart disease as the dependent variable. Gender was the key independent variable while controlling for the other patient and disease variables.


RESULTS
The 490 respondents (1217 surveys sent, 40.3% response rate) included 348 men and 142 women who were similar with regard to race and type of acute coronary syndrome event experienced. Women were older, less educated, had a lower DASI score, had more symptoms, and were taking more medications. However, they perceived their cardiac disease as being no more severe than the men. The significant predictors in the regression model of perceived severity included gender, DASI, number of symptoms, type of acute coronary syndrome event, and comorbidity. Female gender was associated with lower perceived severity (odds ratio 0.30-0.80).


CONCLUSIONS
Women rate their cardiac disease as less severe than do men when controlling for other measures of cardiac disease severity.
Nau
David P
DP
College of Pharmacy, Cardiology, University of Michigan, Ann Arbor, Mich 48109-1065, USA.
Ellis
Jeffrey J
JJ
Kline-Rogers
Eva M
EM
Mallya
Usha
U
Eagle
Kim A
KA
Erickson
Steven R
SR
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000517:prevention & control / Q000523:psychology* / Q000628:therapy; D001294:Attitude to Health; D002317:Cardiovascular Agents / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D005783:Gender Identity; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control / Q000523:psychology* / Q000628:therapy; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012649:Self Concept; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013577:Syndrome; D014930:Women / Q000523:psychology*
D002317:Cardiovascular Agents