You know it’s Heart Month when scary facts about the dangers of heart disease start flooding our screens. But that kind of Heart Month messaging is so pre-COVID – long before September when we learned the shocking results of the American Heart Association’s national survey. This survey found that women’s awareness of heart disease has actually declined – NOT improved at all! – over the past decade, despite all the inspiring Red Dress-awareness-raising-Go-Red-for-Women campaign efforts out there.
So instead of repeating more scary facts as if I hadn’t read that survey’s results, I’m simply offering some weird stuff I’ve learned over the years about women and heart disease: . .
1. Weirdest example of the cardiology gender gap: This 2018 study tracked four years of National Emergency Medical Services Information System data. Researchers found that, if you’re a female heart patient being transported to the Emergency Department in an ambulance after calling 911 for help, you are less likely than male patients to receive recommended cardiac treatments en route (even aspirin!) – and also significantly less likely to have the ambulance sirens or flashing lights turned on.
2. Weirdest heart attack symptoms in women:
- “My lips went numb”
- “I had only a persistent cough”
- “My bra felt too tight.”
3. Weirdest husband-and-wife heart attack experience: One of my readers had a heart attack just eight days before her husband’s heart attack, which was how she learned firsthand the differences between how men and women can be treated.
4. Weirdest out-loud comments from cardiologists to actual female heart patients:
- “Honey, you have recently moved away for the first time. You are probably just lonely for your mother. I would go and have a baby if I were you!” (aortic and mitral valves replaced, pacemaker implanted)
- “You’re going to need a new job where you can lay down a lot. How about a mechanic? Or a prostitute?” (Prinzmetal’s Variant Angina)
- “That sharp pain is probably just psychological.” (three stents, Peripheral Artery Disease)
5. Weirdest way the human body can help to stop a heart attack all by itself: In about one-third of heart attack patients, the small normally closed blood vessels called collateral arteries can wake up, open wide, and enlarge enough to form a kind of detour around a blocked coronary artery, thus providing an alternative route for blood flow to feed the oxygen-starved heart muscle. Do-it-yourself bypass surgery!
6. Weirdest typo to confuse an unsuspecting public: Dr. Colin Baigent is a co-author of a 2002 study looking at whether daily low-dose aspirin helps to prevent a heart attack, published in the British Medical Journal (BMJ). As Dr. Baigent told a HeartWire interviewer: “In the original print edition of the BMJ paper, the final sentence reads: ‘For most healthy individuals, for whom the risk of a vascular event is less than 1% a year, daily aspirin may well be appropriate.”
But here’s the problem: that last word was a typo. An official correction swiftly issued by the BMJ noted that the final word should have been, in fact, “INappropriate”. It was never the researchers’ intention to say that daily aspirin in low-risk patients was a good idea. Too late! Despite that correction (and a BMJ apology), taking a daily low-dose aspirin to help prevent a heart attack has become normalized among low-risk adults – even with more recent studies offering no evidence that aspirin works for this population.
7. Weirdest cardiology conference findings: Whenever I have attended the Canadian Cardiovascular Congress in Vancouver, it’s been with an accredited press pass so that I can interview researchers working on women’s heart disease issues. But on my first trip in 2011, I learned that, out of hundreds of cardiology papers being presented at this conference, only four studies were about heart disease in women – a reality which then became the Big Story of the entire event, and – weirdly – really helps to explain #8.
8. Weirdest timing of an official scientific statement from a major heart organization: On January 31, 2016, The American Heart Association released a scientific statement on women’s heart attacks, concluding that, compared to men, women tend to be under-treated during their heart attacks. That’s pretty upsetting news, but I couldn’t quite decide which part of the announcement upset me more: that particular conclusion, or the fact that this was the first ever official scientific statement in the 92-year history of the AHA to focus on women and heart attacks. Yes, you read that right. . .
9. Weirdest mismatch of answers to the same question about what it’s like to live with heart disease: This Italian study asked three groups of people with an interest in heart failure (the patients, their family caregivers, and their cardiologists) to describe what it’s like to live with this diagnosis. Over 80% of the families used words like “fear” and “anguish”, yet 70% of the cardiologists used words like “optimistic”. That is weird.
(And by the way, when will cardiologists come up with a new name that’s less hurtful to patients and their families than heart FAILURE?)
10. Weirdest research studies containing NO WOMEN: This turns out to be a long and crazy-weird list, but my personal favourite was the Baltimore Longitudinal Study, which included no women for its first 20 years – because the building in which the study was conducted had only one toilet.
Now, back to the AHA national survey results: they confirm what communications experts like Ann Christiano and Annie Neimand at the University of Florida have been warning us about. As they wrote in their report called Stop Raising Awareness Already, published in the Stanford Social Innovation Review:
“Because abundant research shows that people who are simply given more information are unlikely to change their beliefs or behavior, it’s time for activists and organizations seeking to drive change in the public interest to move beyond just raising awareness.”
“Unlikely to change beliefs or behavior”? Isn’t changing beliefs or behaviors why we dispense so much information about women’s heart disease during a designated Heart Month in the first place? Yet even the AHA’s own survey tells us that what they (and I, and all heart health activists) have been doing IS CLEARLY NOT WORKING to raise awareness. If giving out more and more information did work, the survey wouldn’t have found that over half of the women participating were unaware that chest pain is a heart attack symptom.
My weird and wonderful examples here may simply be a wee distraction from usual Heart Month messaging out there. I don’t know. I don’t have a strategy for this. The 2021 Go Red for Women awareness campaign theme this month includes “a call for women to live fierce” – and I don’t even know what that means.
Q: How does wearing a Red Dress pin during Heart Month raise awareness of women’s heart disease?
NOTE FROM CAROLYN: I included lots of facts, data, information – and yes, more weird stuff – about women’s cardiovascular disease in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 20% off the list price).