Open forum: Women and heart disease

State Sen. Gwendolyn Britt of Prince George’s County was known for her efforts to integrate Glen Echo Park and a train station in Alabama in the 1960s. She was poised to be the lead sponsor for today’s civil rights issue, marriage equality.

Marilyn Praisner, who just finished her third term as president of the Montgomery County Council, was known for her work on education, a growth plan for the county, and many other issues. All of these were smart, talented women who contributed a great deal to the state, and we are all the poorer for their deaths.

What can we do to prevent more talented middle-aged women from premature deaths from heart disease? I am not a physician but my family has a history of heart disease, so I have been thinking about this for many years. Some of the answers lie with doctors, others with women.

First, the American Medical Association, the American Heart Association and health insurance companies cannot publicize enough that fact that heart disease is the No. 1 killer of American women, and that African-American women die of heart disease at a higher rate than white women. Heart disease is six times as likely to kill women as breast cancer, yet women are more afraid of developing breast cancer than heart disease. The National Coalition for Women with Heart Disease has sobering statistics on women with heart disease. Medical organizations could increase their efforts to publicize this information in the media and in lectures at hospitals and women s organizations.

Second, primary care physicians and cardiologists should be aware of the symptoms that women have when having a heart attack and make women aware of them. These include: shortness of breath, back or jaw pain, or nausea, unusual fatigue, difficulty sleeping, indigestion, anxiety or feeling uneasy. They also include a feeling of pain, pressure, or squeezing in the chest, pain in the neck, arms, or stomach; a cold sweat; and light-headedness. If women have these symptoms, they should call 911 within five minutes. Some recommend taking an aspirin immediately, and letting it melt in their mouth.

Third, doctors should routinely test middle-aged women of all ethnic backgrounds for all the risk factors for heart disease. The risk factors tested should go way beyond the usual focus on bad cholesterol (LDL), and include blood tests for: homocysteine, triglycerides, lipoprotein-A, C-reactive protein, and fibrinogen. Doctors should find out how much plaque is in women’s arteries. Cardiologists can order CT scans, angiograms, stress tests, echo-cardiograms and PET scans of their female patients. Female patients should be assessed as thoroughly as male patients. They can do ultrasounds to determine how much plaque is in the carotid, aortic, and peripheral arteries. They can do PET scans, which are 98 percent accurate, to determine if there is a blockage in the coronary artery or if the person has already had a silent heart attack.

Fourth, women should be cautioned that taking calcium to prevent osteoporosis can result in the calcium going to their arteries, unless they take magnesium and vitamin D with it. It may not be worth taking calcium at all if people have a lot of plaque in their arteries.

Fifth, us women need to educate and take care of ourselves. We should find a cardiologist if we suspect that we may be at risk for heart disease. We can ask our primary care physician for recommendations or go to lists of top doctors compiled each year by Checkbook magazine and Washingtonian magazine and look up cardiologists.

A cheap and convenient way of determining if you are a risk for heart disease, is to start by requesting screening ultrasounds of the three main arteries for $49 per test by the traveling Life Line Screening company, which can be reached by looking up Life Line Screening online and putting in your zip code. Once diagnosed with risk factors for heart disease, we should do everything that we can to prevent it, starting with diet, exercise, a healthy weight and regular visits to their physicians. Fish oil (omega-3 fatty acids) has been shown to be highly effective for heart health. A 2005 meta-analysis of 97 clinical studies found that fish oil was more effective at reducing overall mortality than statins (23 percent vs. 13 percent).

*A 2006 study found that fish oil reduced the rate of cardiac death more than cardiac defibrillators did (6.4 percent vs. .8 percent)

*Vitamins B, C, and E have also been shown to lower heart disease risk.

Both doctors and women need to work together to reduce the number of women who are dying from heart disease.

Molly Perkins Hauck, Ph.D., Kensington