It's that time of year again—the American Heart Association is asking women to don red dresses. Just as the pink ribbon campaign for breast cancer prompts women to get their annual mammograms, the AHA, the government's National Heart, Lung, and Blood Institute, and a host of heart disease advocacy groups would like those red dresses to increase our heart disease awareness. Last week when I participated in an AHA panel on women and heart disease in New York, nearly everyone wore red: AHA President Clyde Yancy wore a red tie; TV journalist Joan Lunden wore a brick-red blouse; Lucinda Martinez-Desir, vice president of market development for HBO, wore a garnet knit suit with matching suede shoes, and actress Jennie Garth wore a candy-apple-red cocktail dress. Still, I wondered if all this color is really making a dent in getting women to recognize the signs and symptoms of a heart attack. Do we double-time it to a hospital when we think our ticker is failing?
Well, yes and no, says Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital in New York. She's an author of a new study published this week in the journal Circulation: Cardiovascular Quality and Outcomes. The study found that women's awareness of heart disease as our leading killer has nearly doubled since 1997 but that half of women still don't know the signs and symptoms of a heart attack. These include chest pain, jaw pain, nausea, and shortness of breath. [Here's a list of heart attack warning signs]
What's worse, nearly half of women said they wouldn't call 911—the lifesaving step recommended by the AHA—if they were having symptoms of a heart attack, according to Mosca's study, a random survey of more than 2,000 women ages 25 and older over the past 12 years. "They may take an aspirin or call their doctor instead, which delays treatment," says Mosca. What's shocking, she adds, is that 80 percent of the survey respondents said they would call for an ambulance if another family member appeared to be having a heart attack.
Clearly, many women still feel a need to take care of everyone—except themselves.
The study also found some racial gaps: About 60 percent of white women knew that heart disease outpaces cancer as their leading cause of death, compared with 43 percent of African-American women, 44 percent of Hispanics, and 34 percent of Asians. Martinez-Desir told the panel that cultural barriers play a role in how quickly women get their symptoms treated. Older Latina women like her mother, she says, often believe that fate or destiny controls their health and there's little doctors can do to change that.
Mosca is also concerned about our reliance on drugstore remedies with no scientific evidence showing that they prevent heart disease. Nearly 70 percent of the survey respondents said they took multivitamins to protect their hearts, 58 percent took "special vitamins," and 29 percent said they used aromatherapy.
So what's the single best thing I can do to protect my heart? "Measure your waist circumference every month," Mosca tells me. "A measurement over 35 inches means that your heart is at risk, [and] you don't want your waist size to keep creeping up towards that number." More than body weight, she says, a large waist size has been correlated with high blood pressure, high insulin levels (a precursor to diabetes, which is a risk factor for heart disease), and low levels of the "good" HDL cholesterol and high levels of the "bad" LDL. A large waist usually means a large accumulation of dangerous abdominal fat; this fat churns out inflammatory chemicals that damage arteries. [Here's how to measure your waist size.]
If you do see your waist size creeping up, there are a number of things you can do to reverse it, including dietary changes and increased activity. [Here's a plan to banish the belly fat for good.]