For the past 10 years, during American Heart Month, the American Heart Association’s GoRed for Women campaign has been working to dispel myths and raise awareness of heart disease as the number one killer of women.
•Heart disease causes one in three women’s deaths each year, killing approximately one woman every minute.
•An estimated 43 million women in the U.S. are affected by heart disease.
•Ninety percent of women have one or more risk factors for developing heart disease.
•90 percent of women have one or more risk factors for developing heart disease.
•Since 1984, more women than men have died each year from heart disease and the gap between men and women’s survival continues to widen.
•The symptoms of heart disease can be different in women vs. men, and are often misunderstood.
•While 1 in 31 American women dies from breast cancer each year, 1 in 3 dies of heart disease.
“When it comes to managing risk factors, I’m very aggressive”
Durga Madala, MD
Durga Madala, MD, cardiologist based in the Los Gatos area, says she has many women in her practice who have had heart attacks. For them, the motivation to make necessary lifestyle changes is strong.
“Having a cardiac event is a very, very significant in people’s lives,” she says. “In my role as their cardiologist, it isn’t hard to convince these patients of the need to stay vigilant about the risk factors that led to their heart disease. However, it is hard to convince smokers to quit. Even after bypass surgery, they often give in to the urge to smoke.
“When it comes to management of risk factors -- diet, blood pressure, obesity, sleep apnea, I am very aggressive. I want my patients to go on to lead normal lives, and with medications, risk factor management and a good working relationship with your doctor, I can tell them they have a good chance of doing that.”
Obesity in itself is not a risk factor for heart disease, she says. “Thin people can have heart attacks, too. When you have a bigger body mass, however, your blood pressure goes up, your sugar levels go up, and you tend to have sleep apnea, all of which can lead to further obesity.”
This is why Dr. Madala says she has become more aggressive in suggesting the gastric sleeve procedure to help with weight reduction.
“For patients who are moderately obese, and who have tried many times and many ways to get the weight off without success, I don’t hesitate to suggest this method of weight loss, especially as we have seen that it works in getting diabetes and high blood pressure under control.”
Even though heart disease is the No. 1 killer of women, many women are shocked that they could be having a heart attack and often attribute their symptoms to acid reflux, the flu or normal aging.
“It’s very important that women recognize their sometimes unique heart attack symptoms,” Dr. Madala says. “Instead of crushing chest pain such as occurs in men, women tend to have more nausea, neck pain, jaw pain, a burning sensation in the chest or shortness of breath. Women tend to put others first, but in this situation, put yourself first. Seek attention immediately for these symptoms.”
“Preventing heart disease must start at home with our children”
César Molina, MD
While we have the tools to better diagnose and treat heart disease, says César Molina, MD, cardiologist, the key is prevention, and at the earliest stage of life as possible.
The emerging field of genetic medicine is showing us that heart disease is caused by a combination of genes, not just one but many, interacting with behavioral and environmental factors. While we hope to learn more from our study of genes, lifestyle factors, such as nutrition, sleep, stress and physical activity, play a significant role in whether someone develops heart disease.
“Prevention must start in the home with our children,” he says. “So much of prevention involves maintaining a healthy lifestyle. When children learn these healthy habits at home, they will carry them throughout their lifetimes. The earlier we start with prevention, the better chance we have of avoiding coronary artery disease.”
Heart disease rates among men have dropped in California, he says, while the rate has risen 15 to 19% among women. The mortality rate has also dropped among men, but has seen a rise among in women – up to 19% in South Asian women. Dr. Molina says many of the factors contributing to this rise can be traced to adolescence.
“More women than men smoke now, a habit which typically starts among teens,” he says. “Boys tend to continue with sports during their teens and early 20s while girls tend to become inactive, perhaps one reason why we see obesity more in women.”
According to the American Heart Association, being obese puts a huge strain on your heart, increasing the work it has to do. Too much weight raises your risk for heart disease, stroke diabetes and cancer, raises blood pressure, blood cholesterol and triglyceride levels, and lowers HDL (good) cholesterol levels.
“Studies have shown than management of risk factors such as obesity have a positive impact among the normal population, but that once diabetes occurs, it is harder to lower your risk of heart disease,” he says. “I can’t think of better reason to prevent obesity in the first place”
Dr. Molina also calls attention to new findings that show that while women have a higher rate of angina (chest pain) than men, the causes are not always apparent when an angiogram of the coronary arteries is done.
“Women need to be mindful that their angina may be an indicator of what we call cardiac dis-metabolism, or lack of oxygen to the muscle despite open arteries. Pay attention to your family history of angina and see your physician if you are experiencing these symptoms.”
Take an important first step – schedule a personal heart risk screening
Coronary artery disease is a global epidemic among South Asians—men and women who trace their origins from India, Pakistan, Bangladesh, Nepal, and Sri Lanka. South Asians experience coronary artery disease at rates four times higher than any other race. The South Asian Heart Center has developed the AIM to Prevent methodology (Assessment, Intervention, and Management) to address the unmet clinical need for aggressive screening and risk factor modification in this high risk population, while educating participants and physicians in the process.
To schedule your personal AIM to Prevent™ screening with the South Asian Heart Center, please sign up at www.southasianheartcenter.org/getscreened. Call 650.940.7242 once you have registered to schedule your risk assessment, advanced laboratory work, and brief physical exam. Your laboratory tests are covered by most insurances and you are responsible only for your out-of-pocket copayment and deductible expenses. Review your out-of-pocket costs at: https://www.southasianheartcenter.org/contactus/infoBox.php
More facts about heart disease
Coronary heart disease, caused by the buildup of plaque in the arteries to your heart, is the leading cause of death in the United States for men and women.
•About 600,000 people die of heart disease in the United States every year–1 in every 4 deaths.
•Heart disease is the leading cause of death for both men and women and is more deadly than all types of cancer combined.
•Coronary heart disease, the most common type of heart disease, kills more than 385,000 people annually.
Durga Madala, MD
Dr. Madala received her medical degree from Guntur Medical College. She completed an internship at Elmhurst Hospital Center-Mount Sinai Services and her residency at Sinai Samaritan Medical Center, Wisconsin. She did a fellowship at Moffitt Hospital, UCSF Medical Center and California Pacific Medical Center. Dr. Madala is board certified in internal medicine with an added certification in cardiovascular disease. Her special interests are in echocardiography and nuclear cardiology, in both of which she holds additional certifications.
César Molina, MD
Dr. Molina received his medical degree from Yale University and completed his internship, residency and dual fellow ships in cardiology and clinical pharmacology at Stanford University Medical Center. He is board certified in internal medicine, cardiovascular diseases and interventional cardiology. . His special interests are in preventive cardiology, stress reduction, exercise and cholesterol metabolism. Dr. Molina is also the Medical Director of the South Asian Heart Center at El Camino Hospital.
About the South Asian Heart Center
The South Asian Heart Center at El Camino Hospital is the first major non-profit response to the growing epidemic of coronary artery disease (CAD) and diabetes among people from the Indian sub-continent. Men and women in this population are at four times the risk of coronary artery disease and diabetes compared to other ethnicities - despite often being vegetarian, non-smoking, and lacking other traditional risk factors. The mission of the South Asian Heart Center is to reduce the high incidence of heart disease through a comprehensive, culturally appropriate program that raises awareness through education, evaluates risk factors for heart disease with advanced screening, and facilitates lifestyle changes with supportive heart-health coaching. The Center aims to be a global center of excellence, to help address the worldwide heart disease epidemic through outreach, education, research, and cardiovascular risk factor screening.