It’s February - heart month – to me, a female cardiologist, it is a reminder of the work we have left to do. Heart disease is the #1 cause of death for both men and women in the US, it kills more every year than all cancers combined. More women than men have died of heart disease in this country every year since 1984, and once a woman is diagnosed with heart disease she will do worse and be more likely to die from it, than a man.
A woman in the US having a heart attack today will wait longer before presenting to an emergency room. She will be less likely to have the classic symptom of chest pain, she will be less likely to have a diagnostic electrocardiogram, and not surprisingly, she will be less likely to be diagnosed correctly. Even if she is diagnosed correctly, she will be less likely to receive all the life-saving therapies we have to treat heart attacks today, and even if the decision is made to give her these therapies, they will be given, on average, at a 13 min time delay compared to a man. For those of us who treat heart attacks, we have a saying, “time is muscle.” And even if you control for all of these variables, a woman will still be more likely to die from her heart attack than a man, and it is the youngest women who have the greatest death discrepancy rates compared to the youngest men. And we don’t know why.
We are working to change this through enrolling more women in clinical research trials, because most of what we have learned about heart disease has come from studies on men, designed by men, and this has greatly benefitted men, but women have not fared as well. Death rates due to heart disease have been falling for decades in this country for men – not so for women – and now death rates due to heart disease appear to be increasing in our youngest adults (age 35-54) and increasing faster in young women.
One of the great things about being a cardiologist is that there is so much we can do to prevent heart disease. Prevention is crucial because too oftern the first symptom of heart disease is sudden death. But to practice prevention, you have to know you are at risk. Awareness that heart disease is the #1 killer of women is increasing, but women are not personalizing this. We are not taking action. Even incredibly powerful women too often become timid when it concerns their health. I had a female executive who apologized to her EMS team for bothering them during her heart attack. Another patient of mine – a life coach – who when she “knew she was going to die” from her heart symptoms put on her make up and packed her bags before calling 911. Even Rosie O’Donnell waited (here is an excerpt of her poem, my heart attack)…
i became nauseous
my skin was clammy
i was very very hot
i threw up
maybe this is a heart attack
i googled womens heart attack symptoms
i had many of them
but really? – i thought – naaaa
i took some bayer aspirin
saved by a tv commercial
i did not call 911
50% of women having heart attacks never call 911
200,000 women die of heart attacks
every year in the US
by some miracle i was not one of them
the next day i went to a cardiologist
the dr did an EKG and sent me to the hospital
where a stent was put in
my LAD was 99% blocked
they call this type of heart attack
the Widow maker
i am lucky to be here
know the symptoms ladies
listen to the voice inside
the one we all so easily ignore
(visit here, for the full poem)
At the Perelman Heart Institute, we take responsibility in educating our patients, their families, and the community about the facts of heart disease; we know that by increasing our society’s knowledge of this disease will in turn help save lives. I hope you will share this knowledge with your family, friends, and community to help us spread awareness on the facts of heart disease, and motivate others to live healthier.
At the 2014 Health Matters: Activating Wellness in Every Generation conference in La Quinta, California in January, Dr. Holly Andersen was a featured panelist on "Closing the Great Health Divide in the U.S." where she shared the importance of education and prevention around women's heart disease. Watch the panel and learn more on how the Clinton Health Matters Initiative is working to improve health for people and communities across the United States.