The State of Women's Heart Health In Maryland
Cardiologists at the University of Maryland Medical Center (UMMC) want Maryland women to understand their risk for heart disease – the primary cause of death for women.
Baltimore, Md. – Cardiologists at the University of Maryland Medical Center (UMMC) want Maryland women to understand their risk for heart disease – the primary cause of death for women. As today kicks off American Heart Month, Maryland's leading heart experts encourage women to be their own best health advocate; know the signs and symptoms of heart attack and heart failure; and learn how to control their weight and blood pressure – the two leading causes of heart disease for women.
While the rate of heart disease deaths for Maryland women is on par with the national average, disparities exist among the state's counties, according to the Centers for Disease Control and Prevention. Women in Baltimore City, Alleghany County in Western Maryland, and in Wicomico and Somerset counties on the Eastern Shore have twice the rate of heart disease deaths than women in Harford, Howard, Montgomery, Talbot and Charles counties. Factors that may contribute to the disparities include emergency and acute heart care access and quality, poverty levels and lifestyle behaviors.
"One of the most important things a woman can do for herself is go to the doctor and find out her individual risk for developing heart disease," says Stacy Fisher, MD, a UMMC cardiologist and an associate professor of medicine at the University of Maryland School of Medicine (UMSOM). "Many women are surprised by what they learn. But the earlier you know your risk, the sooner you can address it and take important steps toward preventing or managing heart disease."
"Women are often the ones taking care of everyone else around them – whether it's their partner, children or parents," says Van-Khue Ton, MD, PhD, a cardiologist at UMMC and an assistant professor of medicine at UMSOM. "Women may not take the time to consider their own health until things have become really serious."
A Heart Story
Maria Burns knows this all too well. At 25 years old, she had her entire life ahead of her – a promising property management career, professional cheerleading with a local sports team, a husband, young son, a house and two cars. Burns, who lives in Bel Air, was excited to be expecting twins. Because she'd had preeclampsia with her first child, she was considered high risk. Preeclampsia is a severe form of hypertension where the blood pressure is elevated and protein spills into the urine during pregnancy.
But at 25 weeks pregnant, Burns suffered a cardiac arrest that sent her into pre-term labor and landed her in the hospital in a coma. That was when she met Dr. Fisher, who specializes in women's heart health and congenital heart disease.
"That day, my life changed forever," says Burns of her 2008 heart event. "Everything was amazing, and then it became a nightmare."
It was the beginning of what would be a long and winding road back to good health. Because her brain had been without oxygen for so long, Burns initially had no memory. She was in disbelief when hospital staff told her she'd had twins. She had to be reminded when to eat, sleep and nurse. That was when Burns got her "best friend," referring to her pacemaker, which sends electric signals to her heart in order to keep it beating regularly. She could no longer work, and instead had to endure extensive brain and cardiac rehabilitation. "I went from eating whatever I wanted to concentrating on sodium content and a heart-healthy diet. I went from exercising for aesthetics to exercising to keep my heart healthy."
Know the Risks
There are many factors that put a woman at greater risk for developing heart disease. In Maryland, obesity and high blood pressure (hypertension) are the most prevalent. About two out of three Maryland women are overweight or obese, while one in three have diagnosed hypertension. In addition, about 12 percent of Maryland women smoke and 11 percent have diagnosed diabetes. The good news is that obesity, hypertension, smoking, diabetes and many other heart disease risk factor can be successfully managed or resolved with lifestyle modification or medication. Other risk factors can't be controlled, such as family history, age (for women, heart disease risk goes up starting at age 55) and preeclampsia.
"Even for the things that are beyond a woman's control, it's better to know about them so we can monitor and work through any issues that come up," says Dr. Fisher.
Maria Burns was surprised to learn that family history played a factor in her own heart health. "My father died of heart failure at age 39," she says. "It never occurred to me that my father's heart disease was good reason for me to also be evaluated – and unfortunately, it almost took me out." Burns learned she had cardiomyopathy, a weakening of the heart muscle that can lead to heart failure.
Know the Warning Signs
In addition to knowing their risk, women should also know the warning signs of heart failure and heart attack. "The signs for women are often under-recognized," says Dr. Ton, who specializes in heart failure. She says that women tend to downplay their health issues, go longer without treatment and may be treated less aggressively. "I want to stress, for women especially, the importance of getting into treatment as early as possible," says Dr. Ton. "If something does not feel normal in a profound or unusual way – for example, if you find that you are becoming short of breath more and more often, or you are getting tired more easily than you used to – these could be signs that something may be going on with your heart." Dr. Ton says often women think they have the flu or pneumonia and it turns out to be heart failure. "Early referral into treatment helps a woman optimize her outcome. If you have heart failure and are already on treatments but not getting better, perhaps it's time to be referred to an advanced heart failure specialist."
A Bright Future
Nine years after her first heart event, although there have been many ups and downs, Maria Burns is finally starting to see light at the end of the tunnel. Earlier this year, she happily rode a bicycle alongside her son – something she previously hadn't been well enough to do. Burns credits Dr. Fisher with helping her learn to be her own biggest cheerleader when it comes to her health.
"I have learned to pay close attention to how I'm feeling so that when something isn't right, I know to get help quickly," says Burns. She also empowers and advocates for her children. "I had cardio workups completed on all three of my children because of what happened to me at such a young age," she says. "I am making sure we are all vigilant about our health."
UMMC's Women's Heart Program helps women prevent, lower risk or manage heart disease. For more information, call 410-328-7877. UMMC also offers free and low-cost health and wellness programs to help with quitting smoking, blood pressure management, diabetes prevention, chronic disease management and more. Call 410-328-8402 or email GetHealthy@umm.edu.
About the University of Maryland Medical Center
The University of Maryland Medical Center (UMMC) is comprised of two hospitals in Baltimore: an 800-bed teaching hospital – the flagship institution of the 14-hospital University of Maryland Medical System (UMMS) – and a 200-bed community teaching hospital, UMMC Midtown Campus. UMMC is a national and regional referral center for trauma, cancer care, neurocare, cardiac care, diabetes and endocrinology, women's and children's health, and has one of the largest solid organ transplant programs in the country. All physicians on staff at the flagship hospital are faculty physicians of the University of Maryland School of Medicine. At UMMC Midtown Campus, faculty physicians work alongside community physicians to provide patients with the highest quality care. UMMC Midtown Campus was founded in 1881 and is located one mile away from the University Campus hospital.