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The leading cause of death among women is cardiovascular disease. The American Heart Association (AHA) has been raising awareness of this epidemic for decades. At the recent Go Red for Women 2023 Red Dress Collection Concert in New York City, Rita Ora and Sheryl Crow performed while Susan Lucci, Tisha Campbell, Teri Hatcher and many other celebrities joined forces to educate the public about a disease where women are less likely to receive bystander CPR than men.
“More women will die of heart disease than any other cause in this country, and we want to have an empowering and uplifting experience so that women realize their health is in their hands,” states Nancy Brown, CEO of AHA. Brown is also aware that women with cardiac issues present differently than their male counterparts: “We do a lot of work through Go Red for Women to help women understand their unique risk factors and how their symptoms may present so that they know when to call 911 if they’re having symptoms of a heart attack.”
Heart Disease Looks Different in Women
Certain heart attack warning signs are the same between men and women such as angina (i.e. dull, heavy or sharp chest pain); pain in the neck, jaw or throat; or pain the upper abdomen or back. However, women are more likely to experience atypical symptoms such as nausea, vomiting, shortness of breath, lightheadedness and unusual fatigue.
As a former primary care physician, I’ve cared for many patients with all forms of cardiovascular disease. Note that heart attack symptoms in women may be vague and less noticeable than the classic ‘crushing chest pain’ image often associated with men having heart attacks. Emotional stress can also play a larger role in triggering heart attack symptoms in women.
“Like most women, I ignored my symptoms,” confessed Susan Lucci, the legendary star of All My Children who underwent an emergency cardiac catheterization in 2018 and received stents to open up two severely blocked arteries. “Even on my way to the hospital when I felt like I had an elephant on my chest, I was thinking, ‘But I have so much to do, it’s my day off, I can’t do this.’
The Emmy-winning actress and author agreed that women prioritize everyone else but ourselves: “We take our children to the pediatricians right away,” said Lucci. “So, my message to women is to pay attention to your symptoms and put yourself on your to-do list.”
Heart Disease and Black Women
The AHA reports that heart disease and stroke disproportionately affect Black women in the U.S., claiming over 50,000 lives each year – a sad reality not lost on the star-studded Go Red for Women red carpet.
“I always talk about someone’s well being dry. You cannot give to everybody else – husband, partner, friends, work – if your well is dry,” shared Tisha Campbell, star of Martin and Uncoupled on Netflix. “You have to fill your cup up. You have to take care of yourself. How are you supposed to give to everybody if your well is dry? You can’t.”
According to the AHA, only 39% of Black women recognize that chest pain can be a sign of a heart attack. In addition, among the 58% of Black women ages 20 and older diagnosed with hypertension, only 20% have their blood pressure under control.
Star Jones, lawyer and television personality, has a clear message to clinicians regarding Black women’s heart health: “Listen to your patients. When I was diagnosed with heart disease, one of the things I believe saved my life was that my doctor was very in tune with changes in my body. Some of the symptoms of women’s heart disease really mirror what is traditional anxiety, stress, lack of sleep. But when you put all of that together, plus fatigue, it is absolutely imperative [to rule out] heart disease.”
Heart Disease and South Asians
As a female physician of Indian descent, I am affected by heart disease personally and professionally. My own father – a lean, active, lifetime non-smoker – experienced a heart attack (i.e. myocardial infarction) over 20 years ago, underwent coronary bypass (“open heart”) surgery and is now dealing with the common complication of heart failure. My dad’s not alone. According to the American College of Cardiology, South Asian individuals have a four-fold higher risk of cardiovascular disease than the general population. While South Asians comprise about 25% of the world’s population, they account for 60% of global heart disease cases.
Heart disease among South Asians was a topic over which rising new actress, Maitreyi Ramakrishnan, and I bonded (we gushed over being fellow-Canadians, too!)
“Not a lot of research goes into women’s health, first of all,” said the star of Never Have I Ever and the upcoming Netflix rom-com, The Netherfield Girls. “Within that, there’s a priority list of which women get help. On top of that, in our community, there’s such a normalization, ‘Oh, it’s nothing, don’t worry about it.’ South Asian communities neglect their own health so often, we’re too busy, working hard, hustling. But we have to slow down.”
I shared my own mother’s story. She has hypertension and diabetes, but spends all day as the primary caregiver to my father, administers his medications, cooks, cleans, handles the finances and then at the end of the day, finally sits down to have dinner and relax. Over the last few years, she’s neglected her own health, suffering from shoulder and back injuries. This resonated with Ramakrishnan: “In South Asian families, we have an expectation of taking care of our elders. I love that. I’m very lucky to have been raised by my grandparents in a four-generational household while my parents were working. But we care-take so much that we forget to check in ourselves.”
Navigating Stress and Heart Health
Greater stress may deepen the disparity between Black women and access to care. The Jackson Heart Study – the largest clinical trial of cardiovascular disease in Black Americans – found that Black women report unusually high levels of chronic stress which was associated with increased hypertension, a known risk factor for heart attacks and stroke. Several celebs shared their methods for managing stressors from the entertainment industry.
“My mom had a heart attack in her late 60s so I’ve continued to work with AHA and celebrate Go Red for Women to continue the advocacy,” described Elizabeth Röhm, star of Law and Order. “This is a moment to pause and celebrate, but remember that our hearts are vulnerable.”
Food and physical activity are keys to reducing stress for actress and entrepreneur, Lucci: “You learn as you go. Pilates is a big help. I work out every single day. I love the results. Helps me de-stress. I watch my diet.”
Kyle Richards, star of The Real Housewives of Beverly Hills, agrees. “Eating right and exercising – outside of family and friends, these are my top priorities. It’s how I start my day. Lifting weights, doing cardio, making sure everything I put in my mouth is working for me.”
Self-Care is Key
Self-care is not only NOT selfish, it’s critical for self-preservation. Growing evidence shows that self-care can help manage stress, increase energy and reduce the risk of illness. For comedian, Phoebe Robinson, laughter is essential to her self-care routine.
“I grew up watching sitcoms like Moesha, Seinfeld, Friends,” said Robinson, creator and co-host of HBO’s 2 Dope Queens. “We’re all so stressed out, especially women because we’re juggling so much. There’s not enough joy in the world right now, so I think it’s important to have those moments of levity.”
Campbell loves her self-care routine: “I do adult coloring. I love painting. Singing, walking, exercising. I love to write. These things help me calm down.” I also shared my love for coloring, and its calming effects on my nerves.
Athletes, Heart Health and Mental Health
Not too many men were walking this particular red carpet, understandably. But this gala was everything to French Open doubles champion, Murphy Jensen. “This event matters to me. It’s the most important event I could be at. The impact of the American Heart Association goes beyond words,” declared the tennis star. “The work they do saved my life. A year ago, my heart stopped for 18 minutes on a tennis court.” Jensen has also been open about his recovery and mental wellbeing: “My heart function is directly connected to my mental health. My family always says, ‘Leave room for a miracle.’ By the grace of God, I was granted a miracle.”
What’s the Solution?
Start by reducing risk factors for heart disease: control blood pressure and cholesterol; stop smoking; prevent or treat diabetes; maintain a healthy weight; and stay active. Another key step is to recognize the warning signs, and don’t delay in getting help. Doctors will obtain a full history and physical, obtain blood work and order the appropriate tests (e.g. EKG, stress test, angiogram, etc.) If you’re prescribed medications, take them regularly and as prescribed. Remember, heart disease is very much preventable and treatable. We need women to take care of themselves which may include delegating tasks to others and scheduling moments of self-care, be it a walk, a massage, a movie … or coloring.
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