When someone says heart attack, what comes to mind? Most of us assume the victim is a man—and probably overweight, possibly a smoker, and likely to have an anger problem. And we’re probably wrong.

Dr. Jennifer Haythe wants us to know that cardiovascular disease is an equal-opportunity risk. “It’s the No. 1 killer of men and women, and more women die of cardiovascular disease than all cancers combined,” she explains. “People think more women die from breast cancer or lung cancer.”

Haythe is assistant professor of medicine in the Division of Cardiology, Center for Advanced Cardiac Care at Columbia University. She’s also co-director of the Columbia Women’s Heart Center and a sought-after expert by national media, from Self and Woman’s Day to People and PopSugar. She’s drawn to things that have some risk, some complexity and some urgency—and that’s what led her to cardiology. “I like treating advanced heart failure and I enjoy taking care of pregnant women with heart disease,” she says. “I feel like there’s so much that we can do: we can place stents in clogged arteries, perform valve surgery and even provide heart pumps and ultimately heart transplant. We can make a big difference which feels great.”

Lose the stigma and see a primary-care doctor

Haythe says that most people are embarrassed about heart disease because they think it shouldn’t happen to a woman or it shouldn’t happen to them. She urges patients to get over the shame: “The good news is, unlike cancer where sometimes you can’t do anything, there’s so much you can do.”

Eighty percent of heart disease could be preventable, according to research, and Haythe says a big part of management is risk factor screening. “Even if you exercise and eat well, that doesn’t mean that you don’t have high blood pressure—another silent killer—or diabetes or high cholesterol,” she explains.

In fact, a family history is incredibly predictive. “Someone who may be a marathon runner but whose father had a heart attack when he was 39, or whose mother had a heart attack when she was 40, and those events are very, very predictive,” she says. The first step to cardiovascular health isn’t guessing at the changes you need to make to your diet or exercise regimen. “You need to see a doctor first,” Haythe says. “That way, you can be screened for those risk factors younger and do a stress test if that’s required.”

Going once every few years isn’t good enough, and an annual gynecologic visit doesn’t necessarily count. “Everyone should visit their primary care doctor once a year,” regardless of their age, Haythe says. The OB-GYN will check blood pressure, pulse and weight, and that’s important, but cholesterol, diabetes and screening for cardiovascular family history are typically not part of the exam.

Get the real family story

Before you see your health care provider, get the facts about your family. “Women, in particular, should ask their mothers what their medical problems are and how their grandparents died,” Haythe advises. “We often know they had colon cancer, but we don’t know what caused their death. Did they actually die of cancer or was it really something else?”

Your doctor will ask risk-factor screening questions and get a family history of cholesterol, blood pressure, diabetes and other conditions that now are known to be indicators, such as pre-eclampsia during pregnancy and pre-term labor. He or she also will assess you for an exhaustive list of symptoms.

Do you feel short of breath? Do you get chest pains? Do you get palpitations?

Haythe says if you say you feel fine and exercise five days a week, the doctor is unlikely to order a stress test. “But if you’re 35 and you say, ‘My mother had a heart attack at 40 right after she had a baby, and I’ve been noticing that my chest gets a little tight when I go up the stairs,’ you may have a stress test ordered,” Haythe advises.

There is sometimes a fine line between ignoring something and becoming overly concerned, for both patient and doctor. “Unfortunately, there is a lot of medical bias against women, and many doctors themselves don’t realize that cardiovascular disease is the No. 1 killer of women,” Haythe says. If your concerns are being dismissed as “just anxiety,” she advises to find a doctor who will take your symptoms or concerns seriously.

At the same time, Haythe notes that knowledge of family risk factors can provoke worry. “Sometimes that’s driving some symptoms,” she explains. “It’s better to check [and find out you’re OK] than ignore it. If you do find something that could be managed, you could be alive for another 50 years with your children.”

The right plan is the plan you follow

Haythe recommends a healthy diet and exercise, and she reminds people that exercise is a cheap solution: “Everyone has to get a pair of exercise sneakers or some running shoes at some point, and all you have to do is start going for a walk three or four days a week, 15 minutes a day. Then go to four days a week and move up to 20 minutes a day. Try to make your pace a little faster.”

When it comes to diet, Haythe cares most of all about what we eat: “Throw out all the processed food. No more junk food. I don’t care if you’re overweight, as much that I care that you’re eating bad food. I’d rather you be a little overweight and eating really well.”

And don’t expect medication to be an easy way out. Haythe’s pet peeve is people’s misunderstanding of the role of meds and cardiovascular disease control. “Blood pressure medication is not a treatment that you take and stop. You will always have high blood pressure,” she says. Haythe laughs and adds, “The reason it’s good is because you’re taking the medication!”

Patients whose blood pressure or cholesterol improves with diet and exercise must stick to their regimen to sustain the benefits, as well. “I tell people, ‘Please don’t just stop your medicine without talking to your doctor. And if you don’t understand how that works, then talk to your doctor so that he or she can explain it,’” she says.

Follow Dr. Jennifer Haythe and her latest articles on Twitter: @DrJennHaythe.

Video credit: Spotmatik Ltd, Shutterstock
Photo credit: lzf, Adobe Stock (hero photo); Credit TBC; Wavebreakmedia, Thinkstock; Eye for Ebony, Unsplash; H Studios, Stocksy

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