When Susan D’Agostino went into cardiac nursing 25 years ago, little was known about women’s heart health. Even after her mother suffered a heart attack, she found scant information in the medical literature because most cardiovascular studies had been done on men.
Conscious of her family history, D’Agostino, 52, has made it her mission to change that. She serves as an ambassador for The Heart Truth, preaching the importance of good coronary health. Launched by the National Heart, Lung and Blood Institute (NHLBI) 10 years ago, The Heart Truth campaign was among the first of its kind, a federal initiative to raise awareness of the perils of cardiovascular disease.
“It’s all about awareness,” says D’Agostino, manager of the Cardiovascular Rehabilitation/Prevention and the WomenHeart Program at Baptist Hospital in Kendall. “If women are more aware of their risks, they’re more likely to check with their doctors and more likely to take steps to improve their health.”
As it celebrates its double-digit birthday, The Heart Truth is highlighting some of the women who, like D’Agostino, have made its campaign a success. In the early 2000s, only 30 percent of women knew heart disease was their No. 1 killer. In 2009 that number had risen to 54 percent, an accomplishment that bodes well for early intervention.
Experts, however, say that’s not enough.
Heart disease kills more women than all forms of cancer combined, accounting for one in three deaths in the United States. More than 41 million women live with some form of cardiovascular disease, 609,000 of them in Florida alone. And women who have had heart attacks are more likely to die within one year than men who have had a heart attack. Experts speculate it stems from lack of awareness and the quality and promptness of care.
“We’re definitely making strides and more women and clinicians are aware of the risk,” says Dr. Nakela Cook, a medical officer in the Division of Cardiovascular Sciences at the NHLBI. “But now we have to transition from awareness to action. We have to get the general public to work on lowering risks.”
That’s happening to a certain degree. Women who are aware of the dangers of heart disease are 35 percent more likely to be physically active and 47 percent more likely to report weight loss. But the medical community is fighting an uphill battle to stem the rising rates of obesity and diabetes, both risk factors in heart disease.
Because heart disease can feel different for women, many are also slow to recognize the beginnings of a heart attack. Angina, the telltale pressure or pain in the chest, is not always present in women. They may instead experience nausea, back pain, jaw pain, sweating or shortness of breath. They may also feel inordinately fatigued.
What’s more, “we have to worry about certain segments of the population,” Cook says. “Their rates are either plateauing or not improving.”
Minority women face the highest risk for heart disease. About 27 percent of African-American women are overweight and another 50 percent are obese. More than 45 percent have high blood pressure. They’re also less aware of their cardiovascular risk factors and have less access to health care.
In studies of Mexican-American women by the Centers for Disease Control and Prevention, 61 percent of Mexican-American women have high cholesterol levels, 29 percent have high blood pressure and more than 76 percent are overweight or obese. Diabetes in Mexican-American woman is also two times higher than for Caucasian women.
“In some cases, there are some cultural factors, some genetic factors involved,” says Dr. Robert Hendel, professor of medicine and director of cardiac care at the University of Miami’s Miller School of Medicine. “But we have to ask ourselves, Is our message getting to this population?”
While research on women with heart disease is improving, Hendel and others suggest more targeted studies aimed at high-risk groups — and more messages targeted to minorities. “The awareness is just not there,” he adds. Women must understand “you can’t change who your parents are, but you can change some of the risk factors."
D’Agostino would add another at-risk group: young women who dismiss heart disease as a problem for their older sisters. But “it’s an ageless disease,” she says. “Anyone can have a heart attack. You can be your 30s and have a heart attack.”
Yaskary Reyes, 51, of Weston knows that all too well. Her mother died of a massive heart attack at 38, the aunt who helped raise her at 41. One cousin who lives in Puerto Rico had his first heart attack at 23.
Two years ago, she felt a slight pressure around her left shoulder and immediately phoned her cardiologist. After tests showed she had several arteries obstructed, she underwent open heart surgery. Reyes has become a stickler about her blood-pressure medication, doctors’ visits and EKGs. She doesn’t eat red meat, avoids fatty foods and exercises.
“I’ve changed my life,” says Reyes, an executive assistant, “because I know that by the grace of God I’m still here.
Like D’Agostino, she is intent on spreading the awareness gospel to women as a network coordinator for WomenHeart, a campaign of the National Coalition for Women With Heart Disease. She believes prodding women to take action is especially important because of the harried lives they lead.
“We wear so many hats and have so many responsibilities that when we feel the symptoms we tend to ignore them,” she adds. “We figure we‘ll get to that later. And sometimes there’s no later.”