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Heart Health Myths Every Woman Should Know (and What Actually Matters) · Healthy Vitals

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  Scott Webb (Host): This is Healthy Vitals, a podcast from Summa Health.
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  I'm Scott Webb.
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  Today, we're going to do a little myth-busting about preventative
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  cardiology for women with Dr.
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  Brianna French.
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  She's a cardiovascular disease specialist with Summa Health.
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  Dr.
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  French, nice to have you here today.
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  We're going to talk preventative cardiology for women.
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  And what does that mean?
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  You're going to tell us, of course.
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  And we're going to do a little myth-busting along the way.
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  And, you know, when I think of preventative cardiology in quotes,
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  like saying that out loud, or when you do, what are the biggest levers that
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  make the most difference for patients?
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  Dr. Brianna French:
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  You know, the thing that excites me most about cardiology and the reason
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  why I went into the field is prevention.
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  And kind of depending on what study you look at, we think that about 80% of
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  premature heart disease and strokes can actually be prevented by kind of, as
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  you said, pulling some different levers.
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  People think that prevention is some complicated medical mystery.
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  But honestly, the American Heart Association kind of
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  already gave us the playbook.
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  They talk about their Life's Essential 8, and I talk about that with a lot
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  of my patients, that those are kind of really the things to hone in on.
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  And that's, you know, eating better, moving more, getting good sleep,
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  avoiding nicotine, maintaining a healthy weight, and really knowing your numbers.
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  So, things like blood pressure, cholesterol, and blood sugar.
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  What's nice about those is none of those things require
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  a prescription from me, so…
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  Host: Right.
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  Dr. Brianna French:
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  I, you know, absolutely use medications when needed, but the greatest impact
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  can often come from the choices that you and I make every day before
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  we may need a procedure or a pill.
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  Host: Right.
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  Yeah.
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  As you say, family history, of course, we can't outrun, but knowing
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  our family history would be good.
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  But behavior, lifestyle, those levers that we can control, like we're in charge
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  here, and we can do things like that.
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  As you say, eat better, exercise more, quit smoking, all of that.
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  And, Doctor, I know there's this, like, persistent myth that heart disease
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  isn't the number one killer of women.
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  What do you want women to understand about their risk and that myth, if you will?
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  Dr. Brianna French:
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  Yes.
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  Oh my gosh.
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  This is one of the biggest misconceptions, I think, in women's health.
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  Host: I'm sure.
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  Dr. Brianna French:
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  Yeah.
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  As you probably know, many women fear breast cancer.
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  And you know, breast cancer awareness is incredibly important, but heart disease
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  remains the number one killer of women.
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  And in fact, it actually claims more women's lives than all
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  forms of cancer combined.
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  And I think that's the real challenge that, as you were kind
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  of saying, most women don't see themselves as being at risk.
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  They kind of think of heart disease as something that happens to older men.
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  I take care of tons of women in their 30s, 40s, 50s who are dealing with high
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  blood pressure, elevated cholesterol, pregnancy-related complications, have
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  had a heart attack or stroke themselves, or have a really strong family history
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  that increases their future risk.
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  That's not meant to scare people.
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  The good news is kind of as we were just talking, you know,
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  a lot of this is preventable.
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  And I think identifying that we're at risk early and starting to make
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  those changes can have a big impact.
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  You know, sometimes I joke with my patients that, you know, us as women,
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  we spend years scheduling mammograms, OB appointments, coordinating, you know,
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  all the pediatric visits for the kids.
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  But, I guess, my message would be just put your own heart health on that list too.
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  Host: Yeah.
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  Make some time, know your risk factors, address them as best you can.
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  As you say, prevention.
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  And, Doctor, this is anecdotal at best, but I've spoken with many, many
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  heart experts, if you will, over the years, and some have told me that
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  women tend to have symptoms or warning signs that are atypical, and others
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  say, "No, it's exactly like men."
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  You're the expert on this call today.
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  Like, what are the symptoms and warning signs that maybe women
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  overlook, maybe their doctors overlook?
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  And then, maybe, you know, in light of some of the more severe ones, serious
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  ones, when should women seek urgent care?
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  Dr. Brianna French:
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  Yeah.
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  So just as you kind of said, Scott, you know, women can have
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  atypical symptoms, but they can also have the classic crushing chest
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  pain like we see in the movies.
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  Host: Having the big one, right?
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  Like Fred Sanford on The Sanford and Son.
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  You're not probably old enough to remember that, but I am.
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  And maybe some listeners are.
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  The clutching the chest, "I'm having the big one."
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  That can happen too, right?
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  Dr. Brianna French:
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  Yes.
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  Yes.
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  That can happen to women just as much as it could happen to men.
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  You know, everyone's different.
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  But women are more likely to experience some other symptoms like shortness of
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  breath, nausea, unusual fatigue, maybe more upper back discomfort, jaw pain
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  or, you know, kind of just a general feeling that something is not right.
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  Host: Yeah.
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  Dr. Brianna French:
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  You know, in fact, this actually hits really close to home for me.
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  Just this past year, my mom started experiencing shortness of breath, and
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  because she has a history of asthma, she assumed it was her asthma acting up.
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  And I'm not going to lie, even I initially thought, "Oh, yeah."
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  Host: "Oh, it's your asthma.
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  You're fine."
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  Dr. Brianna French:
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  Yeah, It's just your asthma.
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  You know, but when her symptoms kind of really persisted and, you know, she
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  really actually advocated for herself to have it looked into further, she
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  ended up having a pretty significant blockage in one of her heart arteries that
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  required a procedure to put into a stent.
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  So, I mean, that really reinforced an important lesson for me that
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  not every heart problem announces itself with that dramatic chest pain.
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  Host: Yeah.
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  And'm glad you sort of set the record straight.
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  As I said, we're going to do a little myth-busting here.
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  And some people may have the classic signs and symptoms, others may not.
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  If you are having obviously the classic, you know, crushing chest pain, call 911.
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  Get to the ED as quickly as possible, right?
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  Dr. Brianna French:
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  Yes, yes.
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  And you know, another thing I would say is women, I mean everyone, but
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  I feel like sometimes especially us as women, we're especially good at
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  kind of explaining symptoms away.
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  We'll blame stress, anxiety, menopause, I'm just out of shape, or I'm just
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  busy taking care of everyone else.
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  But if you feel like you have new symptoms, they're worsening, or
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  specifically if they're occurring with exercise when you're exerting
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  yourself more or causing you to change something you're doing,
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  it's worth getting evaluated.
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  I think all of us doctors would say we'd much rather reassure someone
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  and say everything's fine than have people ignore something serious.
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  And yes, definitely if you're getting that crushing chest pain and you feel like
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  it's the big one, go straight to the ER.
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  Host: Right.
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  Yeah.
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  And you kind of touched on this a little bit, but, you know, women, because they're
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  often taking care of everybody else and they're not prioritizing their health,
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  because of how busy their and stressful their lives may be, I think some of them,
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  you know, in my experience with women in my life, I think that they're just afraid
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  to cry wolf maybe is the expression.
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  And it's okay, right?
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  You're okay if they cry wolf, right?
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  Dr. Brianna French:
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  Yeah.
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  Just like I said, I would rather reassure someone that everything
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  is fine and maybe do some basic testing than have people dismiss it.
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  And a lot of times, we do end up finding significant cardiovascular disease.
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  Host: For sure.
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  So, doctor, if a patient was only going to track just a couple things, right?
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  They just can't be bothered with everything, but let's just say blood
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  pressure, cholesterol, the biggies, the greatest hits, if you will.
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  Like, what should they prioritize and why?
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  Dr. Brianna French:
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  So, I would say, you know, blood pressure and cholesterol are big ones.
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  I would probably start with those.
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  They're both kind of we think of as silent killers, right?
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  A lot of people can have high blood pressure, high cholesterol, and
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  you're going to feel completely fine.
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  Meanwhile, it's, you know, slowly damaging your heart,
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  brain, kidneys, lots of organs.
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  And, you know, cholesterol is really the big driver of plaque buildup
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  in the heart arteries over time.
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  So, I think knowing those numbers is important.
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  Another one I would say is weight, not because we would be focused on
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  the specific number on the scale.
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  But, you know, we've been kind of talking about different levers
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  you can pull, and that one kind of often impacts everything else.
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  So when you lose weight in a healthy, sustainable way, you're often
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  seeing improvements in your blood pressure and cholesterol, your sleep
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  quality, your energy, and kind of just overall cardiovascular risk.
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  And then, you know, definitely know your family history.
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  That's another big one.
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  I know that's not something to track, but I think just trying to know it and being
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  aware so you can identify if you're at a little higher risk than someone else.
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  Host: Yeah.
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  Knowing your family history, mentioning that to your doctor, "Oh,
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  by the way, my grandma had a heart attack when she was in her 50s."
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  Those really relevant things, right?
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  Those are things we not keep to ourselves.
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  Yeah.
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  So, let's talk about the most realistic starter plan, if you will.
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  I hear 150 minutes a week.
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  That one's burned into my mind.
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  But for exercise, nutrition.
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  For busy women who maybe feel overwhelmed, like how can they get started?
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  Dr. Brianna French:
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  Oh, goodness, yes.
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  I get this question all the time.
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  And I think the biggest mistake I see people trying to make
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  is going from zero to perfect.
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  I fall into that trap myself.
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  You know, I'll convince myself I need some elaborate workout plan that's seven
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  days a week with a perfect schedule.
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  And I don't know about you, Scott.
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  But that is not sustainable for me.
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  Host: Definitely not, yeah.
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  Dr. Brianna French:
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  You don't need a, you know, fancy workout plan, all the latest workouts,
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  and a refrigerator full of kale.
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  I tell people, honestly, just start moving.
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  It's finally getting nicer outside.
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  So, go for a walk around your neighborhood, chase your kids
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  around the yard, take a family bike ride, play pickleball.
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  I enjoy golf, garden, walk the dog.
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  It doesn't matter what you do.
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  Do something you enjoy, and just get out there and get moving.
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  I think we underestimate how powerful just simply walking can be.
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  So, you don't have to train for a marathon.
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  Host: Right.
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  The pickeball thing, you know, is a whole other thing, because I talked to
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  experts at Summa Health, you know, about the types of injuries that they see
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  and, you know, take that slow as well.
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  But as you say, just anything.
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  Get moving, get walking, just do something to get that heart rate up, right?
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  Dr. Brianna French:
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  Yeah.
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  Yeah.
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  And sometimes I tell people, you know, think about what you enjoyed as a kid.
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  You know, because if you don't enjoy the activity that you're doing, you're
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  not going to be motivated to do it.
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  Host: Totally.
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  Yeah.
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  Dr. Brianna French:
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  I kind of tell people to focus on adding instead of restricting.
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  So try to add more vegetables, add more fruit, add more fiber, add more
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  lean protein, those foods that we, you know, think are good for us.
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  And, you know, really just small sustainable changes.
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  You know, I think there's the old adage, the best exercise and
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  nutrition plan are the ones that you're going to actually stick with.
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  Host: Yeah.
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  And I think the key word there that you said was sustainable, right?
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  After the first of the year, you know, we make our New Year's resolutions,
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  but are they sustainable, right?
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  Dr. Brianna French:
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  Exactly.
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  Scott Webb: So, maybe are there some
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  Host: life stages or factors that may prompt women to pay a little closer
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  attention to their heart health?
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  Dr. Brianna French:
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  Yeah, absolutely.
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  Pregnancy is actually one of the most important, I guess, you could
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  think of it as cardiovascular stress tests women will take.
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  So, conditions that people get during pregnancy like preeclampsia, gestational
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  hypertension, gestational diabetes, preterm delivery, those don't just affect
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  your pregnancy, they actually provide us important clues about, you know,
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  a woman's future cardiovascular risk.
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  And what many women don't realize is that cardiovascular disease is
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  actually the leading cause of maternal mortality in the United States.
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  And that's actually a big reason why I'm so passionate about educating women early.
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  You know, as a mom myself, I'm going to get a little choked
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  up, that message hits home.
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  You know, I have a young daughter.
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  And when I look at her, I think, you know, every mom deserves
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  a lifetime with her child.
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  And so much of this is preventable.
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  And it's not just about preventing a heart attack or stroke.
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  You know, I want my patients, my fellow moms, to be able to be there, hopefully,
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  you know, maybe grandchildren one day.
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  So, pregnancy's a big one.
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  Host: Yeah, for sure.
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  And I'm a parent myself and want to be here as long as I can.
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  And, you know, today, through the lens here, we're talking about women,
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  of course, and overlooked signs and symptoms and letting life get
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  in the way of, you know, putting themselves first at least occasionally.
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  So hopefully, we'll have the desired effect here.
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  I just want to finish up here.
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  When women are thinking about the screenings maybe they should ask for
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  and how best to advocate for themselves, what would be your recommendations?
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  Dr. Brianna French:
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  Yeah, I have a couple.
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  And then, one other thing I want to hit with that last question though is
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  menopause is another big transition to kind of think about that really
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  can affect women and heart disease.
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  So, we see kind of different changes in cholesterol, blood pressure.
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  It's not that menopause itself causes heart disease, but it can be a time
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  when risk factors become more apparent.
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  So, I think, that's another kind of stage in life where women
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  should really pay attention.
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  Host: Definitely.
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  Yeah.
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  So then, what about the screenings and how women can advocate for themselves?
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  They're busy, they might feel a little dismissed, whatever it might be.
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  You know, when they come into the office, what should they
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  be asking for maybe and why?
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  Dr. Brianna French:
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  Yeah.
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  As we've been talking about this whole time.
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  So, know your numbers.
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  So, make sure you know your blood pressure, cholesterol, blood sugar.
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  And if you need your doctor to order, you know, basic laboratory tests to know that
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  information, that's really important.
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  Bring up your family history to your doctor, as you had said.
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  One thing that's getting a lot more attention now is kind of a new cholesterol
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  blood test called Lipoprotein(a), or you may have heard of it as Lp(a).
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  Host: Yeah
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  Dr. Brianna French:
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  Yeah, it's actually a genetically inherited cholesterol particle,
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  that very significantly increases someone's cardiovascular risk.
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  Unlike traditional cholesterol, it is very largely determined by genetics.
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  So actually, the American College of Cardiology released new guidelines
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  just this past March that recommend everyone, regardless of age, gender,
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  family history, get screened at least once in their lifetime to know if
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  their lipoprotein(a) is elevated.
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  And it really can inform your doctors how aggressive they
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  need to approach prevention.
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  Another test is a coronary calcium score.
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  That may be appropriate in the right person.
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  It kind of helps us understand whether cholesterol plaque has already
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  started to develop in the arteries.
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  It's not something everyone needs, but it can be kind of a useful tool.
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  So, it's not one-size-fits-all.
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  Kind of how we talked about your age, pregnancy history, family history.
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  Those factors all play in.
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  And never let yourself feel dismissed.
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  You know, whether you're a man or a woman, you know, if you think that
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  something's not right, ask questions.
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  You know your own body better than anyone else.
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  So, I know sometimes being your own advocate can be difficult,
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  but I'd much rather have a patient that's engaged in their health.
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  And I think the doctor-patient relationship works best when
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  both parties are highly involved.
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  Host: Yeah, that's well said.
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  Well, I appreciate your time and your expertise today.
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  I'm not the target audience for this podcast, but I think everyone
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  can benefit from your advice.
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  Dr. Brianna French:
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  You're not off the hook, Scott.
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  Heart disease is still the number one killer in men too.
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  You just get more of the headlines.
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  Host: Of course, yeah.
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  We tend to have the classic symptoms, especially on television and in movies.
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  But listen, I really appreciate your time and your expertise today.
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  It's great having you here.
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  Hope that this benefits listeners.
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  I hope that they, you know, speak with their providers, advocate for themselves,
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  have a little better understanding of the signs, symptoms, which
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  questions to ask, all that good stuff.
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  So, thank you so much.
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  Dr. Brianna French:
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  Yes.
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  No, thank you for having me.
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  It's been awesome.
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  Host: And for more information, go to summahealth.org/heart.
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  And if you enjoyed this episode of Healthy Vitals, we'd love
• 14:57
  it if you'd leave us a review.
• 14:58
  Your review helps others find our educational content.
• 15:01
  I'm Scott Webb.
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  Thanks for listening, and we'll talk again next time.