Just because February is long past doesn’t mean that women can forget the lessons learned during American Heart Month. Heart disease is the number one killer of women, and organizations across the country are working hard to make sure that women of all ages understand their risks and the latest prevention strategies.
On May 4, the Bluhm Cardiovascular Institute and the Health Learning Centers at Northwestern Memorial Hospital will sponsor their Fourth Annual Women's Cardiovascular Symposium, “What Smart Women Need to Know.” We spoke with Marla Mendelson, MD, medical director of the Center for Women's Cardiovascular Health at NMH and speaker at the conference, for a preview.
There’s been a surge in efforts over the last ten years to increase awareness about the prevalence of heart disease in women, and to dispel the idea that heart disease is just a problem for men. How effective do you think these efforts have been?
These efforts have actually [been going on] even longer. You can probably trace it back to the mid-nineties, so it’s been more than ten years that we’ve been talking about it. The Go Red campaign is the more recent, and there’s the Heart Truth campaign.
I think these have made some difference. But I think there are still women out there who don’t believe it; maybe they’re just in denial. We still have to get the message out there, and women are still surprised when you tell them. They think that their biggest risk is breast cancer. If they’re a smoker, they might think that their biggest risk is lung cancer. That’s what they’re concerned about. So we're still working on it.
I think physicians have gotten the message, but they’re still lacking guidelines for evaluation in women in whom they suspect cardiovascular disease. There are guidelines about the prevention of cardiovascular disease in women, based on evidence. [They show] that we can prevent cardiac disease in women by doing basically the same things we’ve always recommended in men – really focusing on people’s risk factors and implementing lifestyle modifications and, if necessary, medication. So it’s not like we’re dancing in the dark, so to speak, as we were when we were just taking data from studies that were mostly done in men and extrapolating that to women. I think we’ve come some ways, but we still have a ways to go.
Are heart-attack statistics improving along with improved education?
It depends on how you define it, because now we’re intervening during heart attacks. [A patient] still may have a heart attack, but it’s not as big as it was going to be, or we [can stop] it. The thing is that we can do all these great things when people are having a heart attack, but women have to come in. That’s why being aware that you’re a woman at risk is so important.
What we are seeing is dramatic decreases in death after heart attack in men, and we’re starting to see the death rates improve a bit in women. But we’re still trailing men.
How are risk factors different for women than they are for men?
[The big difference] is certainly menopause. Before menopause, women get some protection against coronary disease from natural estrogen, which relaxes arteries and can keep cholesterol lower. Although, if they have diabetes, they really don’t have that protection and they are at risk just like men.
So the age that [women] get coronary disease is [generally] later because of menopause, and by that time they may have other risk factors, or other diseases that complicate their care. But basically they’re the same. It’s smoking, cholesterol, family history, diabetes, and hypertension. Obesity seems to be a bit of a stronger factor in women.
I think that our target group is really younger women who may be at risk. We really want to start looking at women in their forties, as they move toward menopause, because that’s when these risk factors start to emerge.
At the conference on May 4, one of the topics you’ll discuss is heart disease and birth control. How do these relate?
First of all, for a woman who smokes, birth control can not only cause a risk of stroke, but a risk of heart attack as well. And that’s been known for a while.
For women who [already] have cardiac problems, there are some questions about birth control, and the safest approach. For some, birth control is very important, because pregnancy could be dangerous. When women have heart disease, [birth control] isn’t usually a priority topic, and it needs to be.
What else can women expect from the conference?
They will not just be given bad news. We’re going to focus on things that people can do in the positive sense – news they can use. Because this is the month of May, we’re going to focus on some major problems in women. That’s why we’re talking about birth control, varicose veins, and obesity. We’re really narrowing down into information that’s actually useful, and looking at gender issues. It’s around Mother’s Day, so bring a woman you love.
What we wanted to do was get it out of February, because women should be thinking about their health every month of the year. They shouldn’t be thinking of their heart in February and their breasts in October – they should be doing it all year long.
Mendelson will speak at the Fourth Annual Women's Cardiovascular Symposium, "Heart Health – What Smart Women Need to Know," which begins at 8:00 AM on May 4 at Prentice Women's Hospital. For more information and to register, click here.