Women and Heart Disease: The Facts May Surprise You Part 2

Since my focus is always retention and prevention, today I will talk about some important tests that will help women avoid a heart attack – a silent or not-so-silent one – and help prevent heart disease. My goal is to keep you well informed, and hopefully, urge you to speak up, and then step up to take control of your heart and your life.

As I mentioned in Women and Heart Disease Part I, over eleven hundred women were surveyed by the Women’s Heart Alliance about their knowledge of and experience with discussing heart disease with their physicians.

Heart Disease Discussions

While a majority of the women in the survey had a routine physical or wellness exam sometime in the previous twelve months, only 40% of those exams included a heart health assessment, despite 74% of these women having at least one risk factor for heart disease. A tiny number – only 16% – were told by their doctors that they were at risk.

Please take a moment to let that sink in, only 16% were told they were at risk.

To confound me even more, I learned only 22% of primary care physicians, and 42% of cardiologists, felt they were comfortable and prepared to assess cardiovascular risk in women!

The last distressing fact: Only 16% of primary care physicians, and 22% of cardiologists discussed giving their patients life-saving tests I will cover below. 

They also failed to suggest preventive choices to safeguard a woman’s heart health. This makes my head explode! How can this be true in the twenty-first century, with women being the majority of folks in the U.S. (and around the world)?

The short answer: We seem to care more about how we look, and the medical profession may be reinforcing that idea. 

A full 63% of the women responding admitted to putting off a doctor’s visit at least some of the time, and 45% of women canceled or postponed an appointment until they lost some weight. (The reasons they gave were difficulty losing weight or finding time to exercise.)

With our primary care physicians spending on average 17.5 minutes with us, we don’t feel safe enough to reveal additional information about any heart symptoms we may be having or call further attention to what might be wrong with us. We are embarrassed to talk to our doctor, family, and friends about heart health because we think it’s tied to solely to our weight, and not a combination of many other important factors—stress level, emotional health, diet choices, sleep, other medications, and dental hygiene. 

Adding to that burden, many of our doctors are men, and the bias some of them carry about women compels them to discount the importance and risks of heart disease and concentrate primarily on how much a woman weighs.

Heart disease is the number one cause of death for women. 

It kills twelve times as many women as breast cancer, which gets much more press. Heart disease must be addressed first. Of course, we must also remove the stigma and stereotype of “weight gain equals heart disease.” The good news is that those of us who had our hearts checked by a doctor in the last year were twice as likely to feel comfortable discussing the topic with our family and friends.

Now that all the right cards are in my hand, here are three key tests to ask for the next time you see your physician. Together with ways to prevent heart disease, which I will cover next time, I will lay down my Royal Flush in hearts!

Tests for Heart Disease

A Stress Test

The most familiar of the three, a stress test takes less than an hour and serves as the baseline for understanding the health of your heart. It is done on a treadmill – in sneakers and street clothes – with complete supervision. You set the pace, and no one will ask you to do more than you can.

Coronary Calcium Test

This easy and painless test assesses your level of risk for a heart attack by measuring the amount of calcium deposit(s) in your arteries. This is a coronary CT scan, done with the same equipment as a CT scan.

CIMT: Carotid Intima-Media Thickness Test

Another easy, painless and quick test, a CIMT measures the thickness of the inner two layers of the carotid artery, the artery located at the side of your neck. This test can let doctors know if there is any thickening in the artery walls long before you might experience symptoms of a cardiac incident. This test is a sonogram of the carotid artery in the neck—Gel on the neck, quick scan, off the table in fifteen minutes!

If the results of the CIMT are concerning, your doctor will request further tests such as a Doppler Ultrasound—an ultrasound to watch blood flow through the vessels and heart, a MRI angiogram or MRA—which allows her to see inside your blood vessels, or a Cardiac CT scan—a dye-free, multiple x-ray that provides images of the heart and blood vessels. All of these will give defining information about the state of your arteries and risk level for a heart attack.

I often print out the list and give it to women to take to their routine exams. Knowledge is power and in this case, very possibly life-saving.