Hidden Epidemic: Heart Disease in America
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Chapter 5: Heart Disease in Women [8:54]

For women the symptoms of heart disease are often very different, or nonexistent, prior to a catastrophic event.

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Transcript: Chapter 5 - Heart Disease in Women

For women the symptoms of heart disease are often very different, or nonexistent, prior to a catastrophic event.

NARRATOR: Until recently, heart disease researcj focused mainly on men. It was generally believed they were at higher risk than women. But, almost half a million women die of heart disease in the U.S. every year. As with men, it's the number one killer, taking more women's lives than the next five causes of death combined. Many women's biggest health fear is breast cancer, but an American women is ten times more likely to die of heart disease.

DR. PETER LIBBY: The demographics of the heart attack victim are changing before our eyes. The disease is, I'm sorry to say, becoming much more democratic.

DR. WILLIAM CASTELLI: Once a woman goes through the menopause, within 10 years she has caught up to the men, and that is why every day in America more women die of a heart attack or a stroke or some other vascular thing than men, because they caught up rate-wise, and there are more women in America than men.

NARRATOR: Heart disease in women is often a silent killer with symptoms that are very hard to recognize.

DR. ELIZABETH NABEL: Women in particular often experience symptoms of heart disease in a manner that's very different from men. We're taught that angina manifest itself as the substernal crushing chest pain, the elephant sitting on my chest that anyone could detect. Well, in some individuals, that's the case, but in other individuals, it's far more subtle. It's a little bit of jaw pain. It's a little bit of shoulder pain. It's a little bit of back pain, it's a little bit of pain radiating down the arm, or it can be some pain that feels like stomach indigestion.

NARRATOR: Patricia Benson, age 57, fit this profile perfectly.

PATRICIA BENSON: Well the first thing I remember was, um, getting a tightness in my throat, which I occasionally would get once in a while, and I'd treat it myself with an antacid or warm water or anything like that. And it would go away right away.

NARRATOR: The tightness and pain in her throat didn't go away, and Pat ended up in the hospital. The doctors weren't sure what was wrong. Her EKG was normal and her symptoms weren't typical of heart disease. They decided to do an angiogram, and they were completely surprised by what they found—a 90% blockage in one of the main arteries in Pat's heart. She had immediate surgery to put in a metal device called a stent to re-open the artery. The stent will stay in that artery permanently to prevent it from closing up again. But the damage was done; Pat had had a heart attack.

DR. MICHELLE ALBERT: She was extremely lucky. Two-thirds or so of pe—of women who die suddenly from their heart attack never have symptoms.

NARRATOR: Heart disease comes as a shock to most of its victims, even though the Framingham risk factors have been well know for many years.

DR. ELIZABETH NABEL: Every medical student grows up knowing what the risk factors are for Heart Disease. Every physician ought to be able to rattle them off the tip of their tongue. Furthermore, we hope that members of our society, our population, our public, know those risk factors of that as well but denial, still, is a major factor that prevents many of us from recognizing the symptoms of heart disease.

PATRICIA BENSON: I used to walk around saying, 'I don't have high blood pressure. I don't have high cholesterol. I don't have this. I don't have that. I don't have diabetes,' and this was when I was 50 and I'm thinking, 'I'm going to dodge this bullet. It's not going to happen to me.' Um... it did.

NARRATOR: In fact, Pat Benson had overlooked several risk factors for a heart attack.

NARRATOR: She did have high blood pressure, and a family history of heart disease.

NARRATOR: She was also recently diagnosed with diabetes, which often leads to heart disease, because it involves other risk factors like being overweight.

DR. MICHELLE ALBERT: If you look at lots of national studies, you'll see that less than ten percent of people are aware of most of their risk factors. You hear a lot of information in the news about, you know, taking control of your blood pressure, taking control of your weight, trying to exercise. But not until it happens to you or someone you know—a friend, a family member—do you really realize that, oh, this is really a serious issue.

NARRATOR: Pat has two daughters and they are both at risk for heart disease.

DR. MICHELLE ALBERT: They're at risk because they are her daughters. It is likely that they eat similar types of foods, have similar types of activity levels, and so forth, and both things, genetics and environment, increase the risk.

JAMILLE BENSON: Ah, there are a lot of things that we need to, um, think about. Just factoring in, you know, the history of diabetes in the family and now heart disease, um, you know changing your diet, exercising, we're all borderline diabetic.

ALETA HAYES: We're all just eating in moderation and eating the right foods and things of that nature.

JAMILLE BENSON: But culturally it's hard. Like we weren't raised on fruits and berries, like, we, you know, I mean that's not how we ate in our household, to be honest—

ALETA HAYES: I was used to eating chips and a candy bar, and sitting there at my desk constantly stagnant, you know. Now I'm—I am doing some changes in lifestyle, but I'm always going to worry, you know, worry even for everybody now, you know?

JAMILLE BENSON: It's just scary. It's like you don't even—you're not even forced to think about what if your parents aren't around until something happens.

NARRATOR: Pat takes medication for cholesterol and blood pressure, and has been doing well.

NARRATOR: But there's always a chance she could have another problem with her heart.

NARRATOR: It's now one year after her heart attack, and she's having a stress test. Her doctor wants to pick up any possible early warning signs that there could be more heart disease lurking.

NARRATOR: But only a few minutes in to the test, there's a problem.

NARRATOR: Pat's blood pressure is dangerously high. She could be on the verge of another heart attack.

NARRATOR: Luckily, and echocardiogram shows no malfunctions in her heart.

NARRATOR: Still there is no cure for heart disease, its something Pat will carry with her for the rest of her life.

DR. MICHELLE ALBERT: I'm most worried about her having another heart attack. As I mentioned, two thirds of the women who die don't have symptoms prior to dying sudden cardiac death. So it can happen to all of us, including myself. And, you know, we're all mere mortals.

DR. ELIZABETH NABEL: Heart disease is a, really a hidden epidemic. It's—it's a silent disease, and that's the message that we need to communicate to women in—in particular. Do what you can to reduce those risks so you never get to the point where you have a heart attack. The far easier road, for sure, is to prevent the heart disease from developing in the first place.

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