Symptoms of a heart attack - women and health.

Do me a favor before reading any further – close your eyes and take a few moments to try and recall the symptoms of a heart attack… for women!

https://www.youtube.com/watch?time_continue=936&v=xnPq_MVv22c

Were some of your guesses the feeling of an elephant sitting on your chest, numbness, or shortness of breath? Well, for both males and females, the most common heart attack symptom is chest pain or discomfort; however, women are more likely than men to experience shortness of breath, nausea/vomiting, and jaw pain/back pain (AHA, 2018). How easy would that be to pass off as having the flu or a minor issue that you’ll deal with later. Although heart disease is thought of as a “man’s disease”, each year the mortality rate is about the same for males and females. Did you take the poll on my facebook page? If so, check and see how many females selected males as their answer. Though increasing efforts of awareness have been made, the CDC reports that only 54% of women recognize that heart disease is their number one killer (2018).

One of the topics in my Human Well Being course was factors that impact the health status of women, as well as gender differences in health. Part of our lecture was watching a Ted Talk lecture addressing how femininity and masculinity are often ignored in healthcare. It really got me thinking, so I included the link above if you’re interested in watching! Whilst taking a study break (aka binge watching the newest season of Grey’s Anatomy), I came across an episode where the chief of surgery, a female, went to a competing hospital ER because she believed she was having a heart attack. They brushed her off and said she was stressed and tried to send her out the door. She was being an advocate for herself (You Go Girl!) and pushed until she got the tests that she requested. Female heart attacks can often be hard to diagnose – thanks a lot hormones!

The presenter of the Ted Talk, Katrine, showed a comic strip of a doctor talking to his patient where he states, “we have research of this drug on fruit flies, mice, hamsters, frogs, monkeys and men, but medical research using women just never occurred to anybody”. Did you know that when drugs are tested on mice, that they use mostly male mice. Why you ask, because their hormonal systems are simpler than females. She then reviewed findings from the Euro Heart Study that only 33% of clinical trial participants are women and that approximately half of the trials did not report an analysis of the results by gender (TedxTalks, 2013). More males are used in clinical trials – again, due to the complicated hormonal systems of women.

That means that the less complications during the trial, the quicker the approval of the drug. Once that drug is approved, your doctor can push it right over to you. What does that mean to you? It means that women who take a new drug are at a higher risk and more likely to develop complications than men. Have you ever taken a new medication and noticed that you’re having additional side effects or find that it doesn’t really help or seem to be working? How could that be? Your doctor recommended it as the best option for you. Well that medication may not have been appropriately tested on females.

I couldn’t agree more when she stated, “We should start taking biological differences between the female and male body seriously and we should give them equal attention in research” (TedxTalks, 2013). Some exciting news regarding research rules, the National Institute of Health enacted new rules mandating that researchers include both male and female samples in their work. Women not only need to be included in research, but the researchers need to include an analysis based on sex to reveal differences to their published work. The Harvard Forum states that there has been a dramatic increase of women participating in clinical trials; however, diseases, such as heart disease, women are still underrepresented (Harvard Forum, 2018).

On the flip side, a lot of attention is given to cancers that affect primarily women (i.e. breast cancer awareness). If you had to pair up males or females to cancer or heart disease, a lot of people think more males die of heart disease than women and that more women die of cancer than men. In case you were wondering, the current data shows that heart disease is the #1 killer and that cancer is the #2 killer of both males and females (CDC, 2018).

Now do you remember the Grey’s Anatomy example I talked about earlier? Do you want to know why else, aside from being a woman, that the chief was the perfect character for this cardiac event? Because she is stressed? Well yes, that plays a role, but not the answer I’m looking for! It is also because she is African American/black. Did you know that African American’s have the lowest survival rate and highest death rate from cancer compared to any other race/ethnicity. African American women also have a higher rate of heart disease than white women. What I love about the writers of Grey’s Anatomy is that they are shedding light on some important topics: health disparities amongst women, awareness about heart attack symptoms, and promoting that sometimes we all need to be our own health advocate. If something doesn’t seem right to you, ask questions, and fight for your health and well-being. You have instincts for a reason. Be your own advocate.

I’ve said it before, and I’ll say it again – prevention is key! Schedule an annual checkup with their Primary Care Provider (PCP) and encourage the men in your life to as well. You should also find out if your employer has a wellness program benefit. A lot of companies are moving towards providing annual health evaluations, which may include tests such as CMP, CBC, PSA, TSH, blood pressure, etc. These tests can help healthcare professionals to assess your risk for complications such as heart disease, diabetes, obesity, thyroid issues, and much more. Many programs offer this benefit to their employees, as well as their spouses!

What else can you do (CDC, 2018)

- Know your Blood Pressure – get it checked regularly

- Talk to your PCP about checking your cholesterol and triglycerides, as well as testing you for diabetes

- Quit Smoking/Tobacco Use

- Make healthy food choices

- Limit your alcohol intake (recommended intake 0 – 1 drink/day)

- LOWER YOUR STRESS LEVELS

Risk Factors for Heart Disease (CDC, 2018)

- High Blood Pressure

- High LDL cholesterol (“bad cholesterol”)

- Smoking

- Diabetes

- Overweight and obesity

- Poor diet

- Physical Inactivity

- Excessive alcohol use

- Stress

Gender differences, race/ethnicity and socioeconomic status are all important factors when it comes to the health status of women. Nevertheless, it is important to note that neither biological nor social perspectives alone can account for gender differences in health (Rose, 2018). Be an advocate for your own health. Ask questions. Educate yourself. Start taking steps to become the healthiest, best version of you!

References

CDC. Leading Causes of Death Health Equity (2018). Retrieved from https://www.cdc.gov/healthequity/lcod/index.htm

CDC. Women and Heart Disease Fact Sheet (2018). Retrieved from https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm

Heart Attack Symptoms in Women. American Heart Association Retrieved from http://www.heart.org/HEARTORG/Conditions/HeartAttack/WarningSignsofaHeartAttack/Heart-Attack-Symptoms-in-Women_UCM_436448_Article.jsp#.W19cJn4naCQ

Heart and Brain Disease in Women. Sex and Gender Connections (2018). Harvard T.H. CHAN School of Public Health. Retrieved from https://theforum.sph.harvard.edu/events/heart-and-brain-disease-in-women/

Rose, P.R. (2018) Health Disparities, Diversity, and Inclusion: Context, Controversies, and Solutions. Burlington, MA: Jones & Bartlett Learning

The problem with Sex and Gender in Health: Katrine Van der Heyden (2013). TEDxTalks Retrieved from https://www.youtube.com/watch?time_continue=1&v=xnPq_MVv22c