Myocardial Infarction

Psychosocial and reported inflammatory disease correlates of self-reported heart disease in women from South of Israel

BACKGROUND

Past and recent research suggests that psychological and biological factors may increase women's risk of coronary heart disease (CHD). This study examined the prevalence and correlates of self-reported heart disease among Jewish women from the Negev, a socio-economically and culturally unique region in south of Israel.

METHOD

A cross-sectional design was used. We interviewed over the phone 526 randomly-selected women (mean age: 44.3+/-14.2 years) about background variables (e.g., education), biomedical risk factors (e.g., body mass index or BMI), self-reported inflammatory diseases (rheumatoid arthritis or RA, urinary infections), psychosocial factors (depression, hopelessness, self-esteem, social-support) and self-rated health and heart disease.

RESULTS

Prior physician diagnosis of heart disease was reported by 8.2% of women. Age, economic difficulties, diabetes, hypertension, BMI, physical exercise, RA and urinary infections were significantly associated with reported heart disease. Of all psychosocial factors considered, hopelessness and self-esteem significantly distinguished heart disease cases from non-cases. In a multiple logistic regression, poor self-esteem, RA and hypertension were significant independent correlates of self-reported heart disease.

CONCLUSIONS

Pending replication with objective measures of heart disease and a prospective design, poor self-esteem and RA may prove to be new CHD risk factors in women.

Application of feminist theory in nursing research: the case of women and cardiovascular disease

Researchers have provided evidence that women recover from and live with heart disease in very distinct ways from men. The challenge for researchers has been to discuss women in a manner that allows their differences to emerge but does not depict them as inferior to men. Our goal is to review current cardiovascular research on women from a feminist theoretical perspective. We believe that a feminist perspective in cardiovascular research will advance the knowledge and recognition of women's health. We examined nine qualitative research articles in depth and applied a model of feminist research critique to them (Bunting, 1997). Historical androcentric notions in women's health and cardiovascular research are discussed. Also included are recommendations for future research to influence social change in women's cardiac health.

Fatty acid compositions of serum phospholipids of postmenopausal women: a comparison between Greenland Inuit and Canadians before and after supplementation with fish oil

OBJECTIVES

We compared serum phospholipid fatty acid compositions, in particular the status of omega-3 polyunsaturated fatty acid (PUFA), of postmenopausal Greenland Inuit women and postmenopausal Canadian women at baseline and after supplementing the Canadian women with a fish-oil product.

METHODS

Fasting serum samples were collected from 15 Inuit subjects from Greenland and 16 non-Inuit subjects from Canada. In addition, eight Canadian subjects provided fasting serum samples after completing a long-chain omega-3 PUFA intervention (2.4 g of eicosapentaenoic acid [EPA] plus 1.6 g of docosahexaenoic acid [DHA] per day) for 28 d. Fatty acid compositions of serum phospholipids of the samples were determined and compared by one-way analysis of variance.

RESULTS

In comparison with the Greenlanders, baseline Canadian women had 73% and 46% less EPA (20:5omega-3) and DHA (22:6omega-3), respectively, and 32% and 91% more linoleic acid (LA; 18:2omega-6) and arachidonic acid (AA; 20:4omega-6), respectively. The omega-3 supplementation in Canadian women increased DHA and decreased LA levels to approach those in Greenland Inuit and raised EPA levels to surpass (45% higher) those in Greenland women (P < 0.0001). In contrast, AA was only moderately lowered (by 16% overall) such that AA levels remained 62% higher in the supplemented Canadians than in the Greenlanders (P < 0.0001).

CONCLUSIONS

Short-term EPA plus DHA supplementation of postmenopausal North American women can mimic the high EPA and DHA levels and lower LA levels in corresponding Inuit women but not the markedly lower levels of AA. The present findings also support the hypothesis of genetically decreased Delta5-desaturase potential in the Greenland Inuit compared with Canadian postmenopausal women.

Warnings about vulnerability in clients with diabetes and hypertension

The purpose of the grounded theory study discussed in this article was to discover and explicate the basic social problem in clients with diabetes and hypertension that affects their adherence to health care directives. In-depth interviews with 21 clients with both diabetes and hypertension and 3 health care providers who care for such clients were concurrently conducted, coded, and analyzed according to the grounded theory method. Clients with diabetes and hypertension described being bombarded repeatedly with warnings about their vulnerability. The warnings were both external (coming from health care providers, family, and friends) and internal (coming from within themselves). Internal warnings were discovered to be far more influential in affecting adherence. This discovery can be used to shape health care providers' social interactions and treatment plan strategies with clients with diabetes and hypertension.