Knowing your risk and tracking your stats can keep you safe.
By Brianna Caleri, Photo courtesy of Lashawnda Walker
According to The American Heart Association, when men and women have heart attacks, they usually feel the same symptoms but report them with different words. Even in the medical field, our social divisions can shape our experiences more than our physical differences. Research from the American Heart Association notes between 2013 and 2016, nearly 45 percent of women older than 20 had some form of cardiovascular disease. In 2016, women represented 49 percent of deaths caused by cardiovascular disease, making it the leading killer of women, more than cancer, accidents and diabetes combined.
Heart disease is especially threatening for women of color. Non-Hispanic black women show the highest occurrence rates of stroke, high blood pressure and heart failure. Although Hispanic women fare better in most categories, they live with the highest risk of diabetes, a major determinant of heart health, and it’s nearly double that of white women.
Dr. Caitlin Giesler, director of the Seton Heart Institute Women’s Heart Center, says she doesn’t think there’s a genetic reason women of color suffer greater odds of heart complications. The vast majority of heart-disease studies have been focused on white men, leaving women—and especially women of color—dramatically underrepresented. That research doesn’t consider issues such as pregnancy or how women metabolize medications—or even include these concerns as part of the research.
That’s why Giesler’s practice focuses on tailoring diagnostic and treatment practices to women’s needs. During her final year of medical school for cardiology, her father died of a heart attack. Giesler and her sister started wondering about their own heath and began to realize prevention information wasn’t geared toward them. Since prevention is key in heart disease, leaving women out of conversations can needlessly cost them their lives.
At only 37 years old, Lashawnda Walker wasn’t prepared to have a heart attack. She ate healthy and exercised. But she had an extensive family history of heart disease, and she started having episodes of low heart rates ending in fainting. One day, while alone in the garage, Walker felt the world crushing in on her. Pain shot up her arm, her jaw ached and her chest constricted. Anticipating a fall, she made sure to drop safely to the floor and called for her son. By the time the hospital started running tests, her heart rate had dropped to the 20s. Her doctors told her she’d had a non-ST elevation myocardial infarction.
Three years later, Walker has a pacemaker—and a mission. She’s active on social media, posting about her experience, keeping up with other survivors and following medical accounts for education and advice.
“There is no age limit on heart disease,” Walker likes to say.
Even on the garage floor, Walker, frightened and alone, could only wonder whether she was having a heart attack. Giesler chalks this up to “confusing messaging” that puts disproportionate emphasis on gendered experience, even though heart attacks usually feel the same for men and women.
If describing symptoms is tough for fluent English speakers, it’s even harder for Latina patients who struggle with the language. One of the recurring themes in the AHA’s efforts to spread awareness is providing materials in both English and Spanish that the public can access without a computer.
Most important, says Jamie Barrett, AHA Austin’s community impact director, are social barriers like finding a relatable doctor, overcoming white-coat syndrome and rewriting cultural stigmas about responding to pain and illness with medication. Most clinics have navigators that can help a patient find, say, a black female doctor, or one who can provide care in Spanish. (The next step as a community is to enable more black and Hispanic women to rise in the medical field.)
Getting women to go to the doctor works best organically from within the community. Barrett reminds minority women, especially in lower-income households, that mothers can only care for their families when they’re healthy and cared for themselves. She also encourages people to distribute information in community gathering places, like at church or child-care centers.
“You want to get care from somebody who understands you,” Barrett says. “And no one’s going to understand that better than a fellow woman.”