HEART HEALTH

Princesses (even Carrie Fisher) get sick, too: Women with heart disease are often ignored

Remembering the actress and writer

 

The tragic death of actress and author Carrie Fisher this week, best known for her portrayal of Princess Leia in “Star Wars”, has shocked the world. According to the latest reports, Fisher suffered a cardiac arrest while flying from London to Los Angeles last week. Witnesses reported that she began to have chest pain and became unresponsive while in flight. CPR was performed and an AED was used to restart her heart.

She arrived at LAX and was transported urgently to the hospital.  There have been no reports that Fisher had any prior heart disease or risk factors for heart disease outside of cigarette smoking and occasional issues with weight.

Carrie Fisher had a long history of substance abuse and, according to some reports, she had recently relapsed. Some believe that this may have been a contributing factor in her untimely death.  

According to the American Heart Association, two thirds of women who die suddenly of heart disease have no previous symptoms—making prevention even more difficult.  Unfortunately, only 54 percent of women recognize that heart disease poses their greatest risk of death.

Women and Heart Disease

Heart disease, while long thought to be a disease of men, actually affects both genders equally.  In fact, more women than men die from heart disease in the United States every single year.

In 2013 nearly 289, 000 women died of heart disease—that is one in four American women.

Heart disease can be more difficult to recognize in women than in men and many women do not even know that they are at risk.

While men tend to present with “classic” heart attack symptoms such as chest pain and shortness of breath, women often have very atypical symptoms including nausea, back pain, flu like illness and feelings of dread.  Many times, women who are having heart attack symptoms do not even realize that they are having a heart attack.

What are the Risk Factors for Heart Attack in Women?

The risk factors for heart disease are similar in both men and women.  There are two types—those that we can modify and those that we cannot.

Modifiable risk factors include: Smoking, high cholesterol, diabetes, high blood pressure and obesity.

Those that we cannot change are our genetic makeup—having a family history of heart disease.

One of the most important things that women can do is to take stock in their own cardiovascular health.  If a woman has multiple risk factors, then screening tests are appropriate.  It is vital that women engage with their health care provider and determine exactly what their risk is—once risk is known, steps can be taken to reduce risk and screening tests can be performed.

How can Women Prevent Heart Disease?

Prevention is all about knowledge — every woman must know her numbers. Here are five numbers to keep track of:

1. Have your blood pressure checked annually.  Hypertension is known as the silent killer.  While you may not have symptoms from high blood pressure, long-standing hypertension can damage your heart and blood vessels and put you at higher risk for heart attack and stroke.  If you and your physician are able to identify high blood pressure early, you can limit the negative effects of hypertension by treating with lifestyle modifications and drug therapy if needed.

2. Have cholesterol checked annually. Most heart attacks are caused by a build up of fatty plaques inside the heart arteries.  When these plaques rupture and occlude a coronary artery, a heart attack occurs.  Cholesterol contributes to the development of these plaques.  By checking your cholesterol annually you can assess your risk and your physician can put you on drugs to lower your cholesterol if necessary.

3. Maintain an optimal body weight—Assess your body mass index (BMI) and make changes to diet and exercise regimen in order to attain a more healthy weight.  Make healthy food choices.  Obesity leads to generalized inflammation and inflammation has been directly associated with the development of heart disease.  In addition, obesity puts you at risk for Type 2 Diabetes as well as high blood pressure, high cholesterol, and ultimately heart disease.

4.  Lower your stress levels. Studies have shown that stress can increase the incidence of heart attack in susceptible individuals.  Emotional stress evokes a hormonal response in our bodies.  When under stress, we release increased amounts of stress hormones including epinephrine and cortisol.  These hormone raise blood pressure and heart rate.  Chronically elevated levels of these hormones can lead to heart attack and stroke in susceptible individuals.  Daily stress lowering strategies such as meditation, exercise and relaxation breathing can make a huge difference in limiting your levels of these hormones.

5. Stop smoking. Smoking is the number one cause of preventable death in the United States today.  While smoking rates have declined over the last several decades, far too many Americans still continue to smoke.  Smoking can cause damage to the heart and blood vessels and can significantly raise your risk for heart attack.  Smoking raises blood pressure, decreases exercise capacity and increases the tendency for blood to clot.  Smoking may be the most important risk factor for heart disease in young women.  If you are a smoker, quit today.  Your doctor can help if you need medications—set a quit date, circle it on the calendar and make your goal public.  Ask friends and family for support.

The Legacy of Princess Leia

Carrie Fisher has done much good in her short life and has brought joy into many lives through her work on film.  Now that she has passed away from a heart attack at a young age, let’s continue to allow Carrie to impact our lives.  Let’s raise awareness for women and heart disease. Let’s help spread the word that a woman’s greatest health risk today is from heart attack and stroke.  While breast and uterine cancers remain a significant concern, heart disease takes the lives of one in four women annually.  In “Star Wars,” Princess Leia fought for a cause that was greater than any one person—let’s let Carrie Fisher’s legacy be one of hope.  Hope that women can now recognize their risk for heart disease and make the changes needed to take control of their own heart health.

Dr. Kevin Campbell is an assistant Professor of Medicine, Division of Cardiology, University of North Carolina and  President, K-Roc Consulting LLC.