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Women who spend nine or more hours a week caring for an ill or disabled spouse have an increased risk of coronary heart disease, according to a new study.

The study shows, however, that providing care for a disabled or ill parent, sibling or other individual did not significantly increase the risk of heart disease, suggesting that the caregiving commitment in these cases may have been less burdensome or less intense.

"Although many caregivers describe their work in rewarding terms, an increasing number of studies have begun to suggest health risks," say Ichiro Kawachi, M.D., Ph.D., of the Harvard School of Public Health and colleagues.

The study was published in the February issue of the American Journal of Preventive Medicine.

Kawachi and colleagues collected data on caregiving and coronary heart disease from 1992 to 1996 for 54,412 women enrolled in a long-term nurses' study. The women were 46 to 71 years old with no prior history of heart disease. During the study period, the researchers documented 321 cases of nonfatal and fatal coronary heart disease among the nurses.

Questionnaires filled out by the nurses tracked how many hours each woman spent in caregiving activities each week and asked them to rate how stressful or rewarding their caregiving experiences were.

After adjusting for other factors such as age, body mass, exercise, smoking and saturated fat intake and a history of high blood pressure or diabetes, the researchers found that the risk of coronary heart disease for the women increased with nine or more hours of caregiving per week.

The researchers found no association between how much stress or reward from caregiving that the nurses reported and their risk of coronary heart disease.

Despite this, "the mental distress from seeing loved ones suffer, added to the stress from financial burdens and the pressures of juggling work with caregiving, may have contributed to the risk of disease in caregivers," Kawachi and colleagues say.

Caregivers may also have less time to look after their own health and fewer opportunities to seek social support outside their homes, both of which might contribute to an increased risk of heart disease, according to the researchers.

More than half of American women will care for a sick or disabled family member at some point during their adult lives. Women are also 1.5 times more likely than men to perform labor-intensive and intimate care tasks, Kawachi and colleagues note.