By Joy Twesigye, MS, NP Women’s Health Editor
I used to not really get the hoopla around breast cancer. I intellectually understood— but emotionally I felt disconnected from the pink, ribbons, marches and walks. Especially when I looked at the data, which shows that the likelihood of dying from breast cancer is dwarfed considerably when you look at the death toll heart disease exacts on women.
I had this intellectual tug of war with my lack of understanding because I consider myself to be a highly empathetic person and after all, I am a Women’s Health Nurse Practitioner.
Two years ago one of my best friends died of breast cancer. It was stage 4 at diagnosis with metastasis to everywhere, two very small children and a husband she had dated since high school. She died a few months after turning 35.
I got it.
But the truth remains that:
Heart disease is the #1 killer of women in the United States.
1 in 4 women die from heart disease.
The chance of a woman having invasive breast cancer during her life is a little less than 1 in 8.
The chance of dying from breast cancer is about 1 in 36.
What keeps me up at night is this:
In the past 30 years, deaths related to heart disease have gone down BUT the death toll for women hasn’t really budged. This means that most of the gains in medication, invasive treatments and prevention for heart disease seem to have benefited men more than women.
Why are women not receiving the same life saving benefits from the gains in heart health as men?
- Scientists from the National Institutes of Health think it might have something to do with Coronary Microvascular Disease (MVD), a type of heart disease where the tiny arteries in the heart are affected. CVD is also called cardiac syndrome X and nonobstructive Coronary Heart Disease (CHD).
- Standard tests for CHD are not designed to detect coronary MVD. WHICH IS HUGE! The regular tests, like a heart catheterization, check the large vessels for plaque and other evidence of disease. You can get a clean bill of health from this test but still have coronary MVD—because it’s the small blood vessels that have problems and are not visualized by the test.
- There is a disparity between how women and men are treated when they hit some hospital doors with chest pain. It has been documented that men receive not only standard care but also more aggressive care than women. Even one Harvard’s hospital admits that gender bias exists.
What are women guilty of?
- We still bypass getting our cholesterol levels checked or ignore elevated results even though our hair would catch on fire if we found a breast lump at home or one was found with a mammogram.
- Some of us passively accept whatever course of treatment is explained (or not explained) to us for early symptoms of heart disease and yet we would see a specialist right away with questionable breast results and DEMAND all the services that we researched about on the way to the appointment.
Get riled up.
Signs that something is amiss with your heart are unfortunately more subtle than the dreaded breast lump.
Research is slow and hopefully one day will produce interventions that will save the lives of women who have MVD.
Your heart is pretty handy, so I wouldn’t wait for research. There are things you can do today.
Do these 5 things after you get riled up about heart health:
1. Check your blood pressure.
Not after you ran to your annual exam and are huffing and puffing. Wait to have it checked until after you get settled. If they check it and it is high or low for you– have them check it again at the end of the office visit.
If you use one of the free blood pressure cuffs in a pharmacy—ask how often the machines are serviced. I know you wouldn’t get on a scale that you didn’t think was balanced or whose batteries were running low.
2. Make sure you know the major side effects of medication.
Some medications raise your cholesterol levels. If you are going to start one that could impact your cholesterol and don’t already have a baseline number get one done so you know your numbers (remember last month?) before you start the medication.
3. Diabetes ruins blood vessels.
If you are diabetic check your blood sugar, take your medicine/insulin, exercise, eat a balanced diet.
The inflammation caused by elevated blood sugar damages the walls of your veins and arteries…you don’t notice…until you have really high blood pressure or have a heart attack.
4. Just as you would be getting yourself acquainted with family history for breast cancer do the same with heart disease.
5. Get to know the standard of care for chest pain, heart attacks and screening schedules. If your health care team thinks you don’t need a heart catheterization ask why…not to be argumentative or dictate care but to get them to explain to you your individual situation and the risk and benefits of each.
You get the deals in the boardroom, with your contractors so don’t skip the details when it comes to your health. You are your best advocate and when in doubt…get a second opinion.
As with anything, your risk for different diseases changes across your life course. So what is relevant for you in this stage of your life may be different from what you worried about 5 years ago and what you should be concerned about 10 years from now.
I only push this because I care. I want you to know—and take action.
*Nothing in this article should be considered a replacement for personalized medical advice/treatment from a health care professional. MyCity4Her does not provide medical advice, diagnosis or treatment.
About Joy
Joy Twesigye, MS, MPP, WHNP-BC has a diverse background in health care that equals over 10 years of direct care delivery, working with government agencies/programs, public and private payers, and health care institutions. While living in Colorado, she was the Clinical Supervisor and Chief Operating Officer for a non-profit women’s health clinic and a health plan manager for Colorado’s Child Health Plan Plus. She received her undergraduate degree from Ohio Wesleyan University, masters in science from The Ohio State University and masters of public policy from Johns Hopkins University. Continuing her quest for answers, she also completed the Bighorn Leadership Program as a Health Policy Fellow and was a Paul G. Rogers Memorial Scholar with the National Coalition on Health Care. Joy is a fervent believer in social entrepreneurship and loves being at the intersection of health innovation, tech, and business. She also blogs at Pitchforks Optional.
Enjoyed the article. Thanks for the heads up.
Glad you liked the article Donna!
Joy Twesigye’s article is interesting to read. It should empower some women, who read it, to ask their medical providers some important diagnostic tests. Some of these tests are the necessary tools that would catch heart disease early and treat it before it kills the patients.
However, some insurances may be reluctant to cover the tests, if they are expensive, unless there is a demonstrated medical cause or prblem.
Heart disease may be ignored because it may sometimes present different symptoms in women as opposed to men. But since heart disease is one of the leading killers of women, especially in the West, women should be more aggresively tested and treated for it.
Joy Twesigye keep up the good work of moblizing and educating both women and men about their health. Information and correct health care knowledge are the necessary and essential keys to empower us to take good care of each other and ourselves. The well-informed and empowered patient is the best medical advocate and healtcare-taker for oneself.
Emmanuel K. Twesigye
Thank you for the comments! Figuring out personalized disease risk can be difficult but it is even more difficult when we don’t have the highly definitive screening mechanisms for small vessel disease (MVD). This not only impacts women’s heart health but brain health as well, since small vessel disease is just as pesky to deal with there as with the heart….and yet you need both to have a highly functional life.
Joy – I didn’t know that heart disease was a number one killer. I very much appreciate your intro about your friend, because it pinpoints the biggest issue – if it’s not personal, people tend to ignore it. Statistics don’t speak as loud as a personal experience. Thank you for sharing both.
Andrea–Thank you so much for your kind words. I think you are right about data–though I love it–people really respond to stories and relate through personal experience. I’m glad you got riled up about heart health too!