Women's Month Highlights the Haunting Reality of Heart Disease

During Women’s History Month in March, the American Heart Association is highlighting a haunting reality: Heart disease is women’s No. 1 cause of death.

“This is the thing most likely to kill a woman and we know it is 80% preventable,” said Dr. Tara Narula, a board-certified cardiologist at Lenox Hill Hospital in Manhattan and CBS News senior medical correspondent.

Close to every 80 seconds, a woman dies from cardiovascular disease, which kills more women than all forms of cancer combined.

“A lot needs to happen” to reduce heart disease among women, Dr. Narula said. “The first thing is awareness, a real understanding that this is their biggest health threat.”

Yet, from 2009-19, the number of women who recognize the deadly potential of cardiovascular disease has dropped from 65% to 44%, with the youngest women, as well as Black and Hispanic women, being the least aware.

“We need to educate women to make heart health a priority,” Dr. Narula said. “Once the damage is done to heart cells, in many cases it can be permanent or disabling.”

She identified three areas to address: disparities in awareness and treatment, concerns specific to pregnancy and lifestyle issues.

Face the factors

• Public health campaigns tend to focus on preventing diseases such as cancer. One in eight women will be diagnosed with breast cancer during her lifetime; more than 43,000 women are expected to die from the disease in 2021. But equal attention needs to be paid to heart health, Dr. Narula said."
  
  As a society, Go Red for Women has been so valuable,” Dr. Narula said of the AHA campaign. “We need to continue to raise awareness with aggressive public health campaigns.”
  
  
• As caregivers and providers, women tend to care for others before themselves.
  
  “We’re so focused on everyone else,” Dr. Narula said. “It’s not our natural instinct to help ourselves.”
  
  
• Many women downplay symptoms that could be signs of heart disease, attributing palpitations to stress and chest discomfort to acid reflux.
  
  “Not understanding the risk, or thinking the symptoms are not related to the heart, or it’s all in their head, is the perfect storm of how women downplay it,” Dr. Narula said.
  
  
• Historically, heart disease research has focused on men, who also die more from cardiovascular disease than any other condition. It accounts for 1 in every 4 male deaths. As of 2020, less than 40% of clinical trial participants were women, an alarming gap that needs to be addressed to ensure research is inclusive of women’s unique needs.
  
  “For a very long time,” Dr. Narula said, “women weren’t enrolled to the same degree in trials as men. It’s taken the medical establishment a long time to get the understanding that we are not just a smaller version of men. We have our own biological makeup and our physiological processes are different."

Pregnancy and heart disease

“One of the big things has been recognizing and understanding that what happens to women during pregnancy can be a marker for future cardiovascular risk,” Dr. Narula said. “If you have gestational hypertension or diabetes, or if you have preterm delivery, those are all markers for increased risk of heart disease and should prompt women to get plugged in.

“Understanding risk factors and things that happen during pregnancy are a few of the biggest ways we’ve begun to move the needle.”

Dr. Narula suggests women talk to their obstetrician about their heart and to get a referral to a cardiologist.

Take these steps for a healthier heart:

1. Know your numbers. What’s your blood pressure? Cholesterol levels? Blood sugar? Body mass index?
   
   
2. Be aware of symptoms you may not associate with heart issues. Besides chest pain, shortness of breath, fatigue, heart palpitations and passing out could all be signs. If you experience them, see your doctor.
   
   “It's important to make sure it’s not your heart before we say it’s something else like a problem with your lungs or stomach,” Dr. Narula said.
   
   
3. Exercise, eat healthy and manage mental well-being.

“It's never too early to start and it's never too late to change,” Dr. Narula said
 
The AHA recommends adults do 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity, or a combination of both, preferably spread throughout the week. It’s also good to do moderate- to high-intensity muscle-strengthening activities such as resistance or weights at least two days a week. But even small changes help. Take the stairs. Walk 10 minutes.

Dr. Narula and her husband, also a physician, encourage their two daughters to play outside even on cold winter days and to eat healthy.

"We educate them about how to live healthy with choices they make every day," Dr. Narula said.

“We teach them to meditate, exercise, sleep. By the time we send them off to college, they can go into the cafeteria and not eat a bagel every single morning because they’ve been taught what to do and why it matters.

And because stress and mental well-being affect heart health, Dr. Narula recommends digital tools to help reduce risk. “They’ll help you learn to meditate, to do yoga or with breathing,” she said.