Heart health

When I started seeing K. last year, she was at the top of her game. At 54, she was a newlywed and a powerhouse at work who exercised and ate healthily. Yet she'd recently had a sudden onset of chest pain at the office. After undergoing a battery of tests at the hospital, she was diagnosed with high blood pressure. K. was shocked. How could she have felt so good and still be facing such danger?

Cardiovascular disease (CVD) is the umbrella term for disorders of the heart and blood vessels, including coronary heart disease, heart attack, problems with the structure of the heart, abnormal heart rhythms, and stroke. It is the leading killer of American women, taking more lives each year than all cancers combined. CVD could happen to you, or to a woman you love. And while it affects women of every background, those of color, like K., are especially vulnerable—yet also particularly unaware of their risks.

Nearly half of black women and around one-third of Mexican American women have CVD, according to the American Heart Association. One of the biggest issues is risk factors: 46 percent of black women and 31 percent of Hispanic women have high blood pressure, compared with 32 percent of whites; 82 percent of black women and 77 percent of Hispanic women are overweight or obese, compared with 63 percent of whites; nearly 14 percent of black women and 13 percent of Hispanic women have diabetes, compared with about 7 percent of whites. Physical inactivity is also a greater problem among black and Hispanic women.

People's beliefs about health can be framed by their background, but we experts haven't done the best job of helping patients understand their risk. While 65 percent of white women know that CVD is their most significant health threat, only 36 percent of black women and 34 percent of Hispanic women do.

We're trying to change that. For my part, I've been asking all my patients, but especially black and Hispanic women, about their family history; diet; stress; and smoking, alcohol, and exercise habits. I inform them of the importance of keeping track of their blood pressure, cholesterol, blood sugar, and body mass index. I also inquire about their pregnancies: Gestational hypertension, gestational diabetes, and preeclampsia are associated with increased future risk of CVD. I use their answers to inform them of their risk level.

We also talk about heart attack symptoms, which can include chest pain, shortness of breath, neck or jaw pain, and fatigue. Most important, I make clear that 80 percent of CVD cases may be prevented: by keeping your numbers in their ideal range, quitting smoking, maintaining a healthy weight, and exercising. I also emphasize the importance of being proactive and prioritizing health. K. is doing just that: taking blood pressure medication, continuing to exercise and eat well, and watching her numbers. Her heart is doing great.

Prevention includes scheduling a well-woman annual exam to discuss health issues before they become serious and to create a care plan just for you. There's no bigger show of love this month than to honor and protect your heart and be an example to the women you hold dear.

Tara Narula, MD, is associate director of the cardiac care unit at Lenox Hill Hospital in New York City and an assistant professor of cardiovascular medicine at the Zucker School of Medicine at Hofstra/Northwell.

From the February 2018 issue of O, The Oprah Magazine