Women's perceptions of coronary heart disease: an integrative review

Coronary heart disease (CHD) is the leading cause of death in American women and is a major cause of morbidity. The American Heart Association (AHA) reports that in the year 2000, 515,661 women died from all categories of cardiovascular disease. An estimated 254,630 women suffer a myocardial infarction annually. Women diagnosed with CHD experienced greater morbidity and mortality than men. Women's perceptions of their risk for heart disease can greatly influence their decision-making process in regard to healthcare decisions. The general public still perceives heart disease as primarily a health problem for men. Evidence shows that women perceive breast cancer as a greater risk than CHD. These misperceptions may lead women to underestimate their risk for CHD and fail to seek early interventions to prevent unnecessary morbidity and mortality. The purpose of this article is to report the results of an integrative review of nursing research related to women's perceptions of risks for heart disease. CINAHL, Medline, EBSCO host, and Proquest databases were searched for nursing research conducted between the years of 1985 and 2002. Key search terms were women, heart disease, coronary artery disease, perceptions, risk factors, and health promotion behaviors. Study selection was limited to the first author being a nurse researcher. Twenty articles and dissertations were retrieved that met the key search terms. Eleven articles were excluded because the first author was not a nurse researcher. This integrative review includes 5 articles and 4 dissertations. Results revealed that women's perceptions of their CHD risks are underestimated, that health-promoting behaviors are not influenced by risk perceptions, that society imposes barriers that prevent participation in health promotion behavior, and that communication between women and their healthcare providers is lacking.