The greatest disease killer of women? It’s not breast cancer. It’s heart disease
By Deborah Jeanne Sergeant
Although the pink ribbon campaigns to raise funds and awareness for breast cancer are important, heart disease represents the disease that kills more women annually than any other disease.
One reason for heart disease death prevalence among women is that even healthcare policy influencers tended to focus more on men’s heart health to the neglect of women’s heart health.
“Even in not-very-distant history, even the American Heart Association addressed women as to how to help their husbands’ hearts,” said physician Nelly Kazzaz, a board member representing the Western and Central New York chapter of the American Health Association.
The medical community has focused so much on women’s health such as lowering childbirth-related deaths and other reproductive issues that heart disease has not been as studied and researched.
When women were included in heart disease research, “the research did not have enough women to apply it. Now we know the differences and have more women involved in the research and can apply the different treatments and diagnostics,” said Kazzaz.
One reason that women weren’t historically as studied in medical research is that fluctuating hormones from monthly cycles, childbearing and menopause were viewed as effects skewing studies’ results. But recent attention on heart disease among women has pushed for more study in this area.
In addition, “there’s lack of awareness among patients themselves,” Kazzaz said.
Women haven’t asked about heart health, perhaps in part because men’s heart health has received so much attention.
That awareness extends to providers as well, Kazzaz added, since women can present with atypical symptoms.
“Women tend to talk about all other issues and not on the symptoms,” Kazzaz said. “They describe it differently to their providers than men. They say, ‘I was attending a wedding, wearing this dress, and they had these flowers, and then was short of breath.’ That might affect how healthcare providers pay attention to their symptoms.”
She added that providers may skip over the pertinent parts of the narrative when discussing health crises with women. Or miss the importance of symptoms that differ from men’s symptoms.
“Many of my patients walk in and say, ‘It’s probably anxiety’ which it might be, but give us the chance to rule it out,” Kazzaz said. “They don’t want to be judged. I’m not saying it’s not a real health issue that needs to be addressed, but they think that if it is anxiety, they’ve wasted my time.”
She assures patients that “false alarms” waste no one’s time. Providers can also use these moments for patent education on topics such as how heart attack presents in women.
“We classically think of chest pain and shortness of breath as the hallmarks of heart attacks, but women can present differently,” said physician Amanda Congiglio, who works at Rochester Regional Health. “If someone doesn’t feel normal, they should be assessed.”
She noted that because so many people rely on women, such as their spouses, children, senior parents and employers, women may feel stoic to push through symptoms like dizziness, flu-like symptoms, and jaw pain.
Prevention Plays Big Role
To reduce their risk of heart disease, women should follow these steps.
• “Be aware of your risk and know your numbers: blood pressure, cholesterol, blood sugar and ideal, healthy weight.
• “Weight, blood pressure, blood sugar, cholesterol, activity level, smoking and sleeping we can change to reduce the risk.
• “In some people, we can start with ‘and if we can’t achieve that, we can look at medication.’ We are trying very hard to catch these patients as young as possible in their child bearing age. Maternal healthcare is a big concern in healthcare with hypertension, diabetes, preeclampsia or eclampsia during pregnancy. OB-GYNs may see indicators. The patient may need referral to a cardiologist.”
— From physician Nelly Kazzaz, board member representing the Western and Central New York chapter of the American Health Association.
• “Don’t smoke. That’s the biggest thing.
• “Get 150 minutes of aerobic exercise a week. Walking is a great way to exercise, and some weightlifting, which is also good for preventing osteoporosis.
• “Eat a healthful diet.
• “People struggling with obesity should reach out to their primary care provider to get started on medicines that help with weight loss.
• “If you have high cholesterol or have diabetes, keep it well-managed.”
— From physician Amanda Congiglio, Rochester Regional Health.
• “A lot of people think, ‘I have to devote an hour of time to exercise.’ And it feels like work. It’s uncomfortable. But they can take a 30-minute walk at lunch and take another 30-minute walk after lunch. If you look at it as a chore, it’s hard to do. There are a lot of things you can do during the course of the day that change the way you see exercise.” People respond to that. They understand we’re busy people. Sometimes, it is easier to use your day as your source of exercise as opposed to fighting it.
— From Vanna Reisman women’s health nurse practitioner and certified nurse midwife.