Heart disease is the number one cause of death among women in the United States, causing 1 in 3 deaths each year.
A major problem is that women often aren't diagnosed until they've had a major event.
Furthermore, the symptoms they experience aren't the same as the crushing chest pain many men have while having a heart attack.
Learn about the latest treatment options for women from Dr. Gretchen Wells, an expert in women’s heart health.
Learn more about Women's Heart Health
Selected Podcast
Women’s Heart Health: Learn the Differences Between Men and Women
Featured Speaker:
Learn more about Gretchen Wells, MD
Gretchen Wells, MD
Specializing in women’s heart health, Gretchen Wells, MD, received her medical degree from the University of Alabama at Birmingham Medical School. She completed a residency at Wake Forest University, Bowman Gray School of Medicine in Winston-Salem, N.C. a fellowship in cardiology at Wake Forest University, Bowman Gray School of Medicine, Winston-Salem, N.C. Wells is board certified by the National Board of Echocardiography and the American Board of Internal Medicine in Internal Medicine and Cardiovascular Medicine.Learn more about Gretchen Wells, MD
Transcription:
Melanie Cole (Host): Heart disease is the number one cause of death among women in the United States, more than lung cancer and breast cancer and all the other cancers combined. It causes 1 in 3 deaths each year but a major problem is that women aren’t diagnosed until they’ve had a major event and the symptoms that they experience are not the same as men. So, how do you know if you have heart disease? My guest today is Dr. Gretchen Wells. She’s a cardiologist specializing in women’s heart health at the University Of Kentucky Healthcare. Welcome to the show, Dr. Wells. Tells us about heart disease and how we women have different symptoms than men.
Dr. Gretchen Wells (Guest): Well, thank you for having me, Melanie. First, women sometimes do have the same symptoms as men: the chest pressure, the classic Hollywood heart attack, if you will. But, with women this can also be a bit more insidious. For example, we may present with some fatigue, shortness of breath, not thinking clearly, symptoms that we want to attribute to something else, just the daily stressors of life. But this can be very misleading and, as you pointed out, we don’t want to wait until it’s too late.
Melanie: So, most of the heart disease studies over the years have been done on men. Heart attack studies, all of those things, they were all done on men. So now, it’s sort of the tide is turning a little and we’re learning so much more about the difference in our women. Now, Dr. Wells, what symptoms do you want people pay attention to? Because, as you mentioned, some of those symptoms we women get could be from perimenopause, or menopause or stress, anxiety--things we all suffer from because we women are busy and we’re caregivers. So, what are those big red flags you want women to really pay attention to?
Dr. Wells: Anything out of the ordinary whether it is chest discomfort, shortness of breath, arm pain, jaw pain, anxiety--anything that is out of the ordinary should always be checked out. It’s great to provide a patient reassuring news and it’s even better to address a problem before it’s too late. So anything out of the ordinary, have it investigated. Maybe it is nothing. Or, maybe it is some psychological stress but we’re professional worrywarts in medicine. We don’t want to take any chances.
Melanie: Women tend to be professional worrywarts, too, and that causes some pains that mimic heart disease. So, what tests do you do so that we do find out?
Dr. Wells: We vary the testing for each patient. For example, if a woman comes in and has EKG changes, abnormal lab work, women go directly to a cardiac catheterization. Other times, if the EKG is normal and the symptoms occur with exertion, a stress test may be in order. There are different types of stress tests depending on the individual characteristics of the woman. Sometimes, she may not have symptoms at all and she wants a risk assessment. That is terrific to get on top of this before any symptoms even occur. Prevention. In that setting, we may do things--we’re not talking about high tech things here—something as simple as checking her blood pressure, finding out how much she exercises, checking her cholesterol, discovering how she copes with stress. Does she smoke, for example? Does she eat too much? Those are the type things that we investigate and we also have some more high tech resources available. MRI’s and so on are coming on the horizon and are terrific tools for investigating small blood vessel disease, if you will.
Melanie: So, what do you want women to know about stress, Dr. Wells, and its contribution to heart disease? Because we are all trying. We hear about managing our stress. Is there a link between stress and heart disease and what can we do about that?
Dr. Wells: Absolutely, there’s a link. We’re only beginning to recently find out more about it. Some stress, of course, is good. It’s what gets me out of bed in the morning but also learning how to cope with this, how to deal with this and coming up with some creative solutions. Daily exercise for example is a great way to alleviate stress and we know that women who exercise, just brisk walking, 30 minutes, five out of seven days a week, reduces your risk of a heart attack by 50%. That’s better than most medications that I can prescribe for you.
Melanie: Well, the American College Of Sports Medicine does say that exercise is medicine. So, how much exercise? Gives us your best prevention tips for heart disease
Dr. Wells: How much exercise? How long’s a piece of string here? But at a minimum I would say 30 minutes, five out of seven days a week. That is from the Nurses’ Health Study. This isn’t something I just pulled out of my head. Some other tips for avoiding heart disease? Stuff your mother always told you, for example. Well, one, of course, would be to pick the right parents. Unfortunately, this does run in some families, such as mine, but that’s an advantage because you know early on “I need to take measures to prevent this from happening.” But, in addition to daily exercise, avoiding tobacco products, keep you blood pressure under control, know your numbers, know your blood sugar, for example. We know our shoe size, we know our bra size and we should know things like our glucose, our blood pressure, our cholesterol and take measures to keep those within the guidelines.
Melanie: So, tell us what women can expect at the Women’s Heart Health Program at UK Healthcare, the Gill Heart Institute?
Dr. Wells: Well, first of all we have a personalized risk assessment program for each patient that walks through the door. We meet with the patient individually. We ask lots of questions. We are detectives. Then, we come up with what the best prevention and treatment strategy will be for that individual woman. So, no two women are alike who come through the door and we recognize that and treat that.
Melanie: What about the multidisciplinary approach? Because heart disease has so many facets to it both in treatment, after diagnosis and prevention, so where does nutrition and even some anxiety and stress management, where do they all play a role?
Dr. Wells: Absolutely, they do. We work closely with our colleagues in endocrinology in the treatment of risk factors such as diabetes, thyroid disease and so on. We work closely with our nutritionists, with sports medicine experts, with our nurse educators and we take a true, team-based, holistic approach. Women prefer that concept. I know I do. It’s been very effective.
Melanie: So, what does the role of nutrition play? What do you want women to know about diet and its contribution and/or aid in prevention for heart disease?
Dr. Wells: Well, you mentioned before that exercise is a medication. Food is, too. What I like to emphasize are a low fat. Well, I shouldn’t say “low fat” but the right kinds of fats. For example, peanuts, fatty fish and so on. Leafy green vegetables, the Mediterranean approach. It can be fun to go to the store and plan meals and they’re not only healthy but they’re good to eat, good for you and fun to plan.
Melanie: What about when we’re thinking of these foods and, of course, women, Dr. Wells, we’re always obsessed with our weight. What role does weight play in heart disease management?
Dr. Wells: Maintain an ideal body weight. We don’t want you too thin. Really, I prefer that the woman be healthy more than thin. We do obsess about our weight too much but as long as the woman is healthy and is within guidelines, I’m satisfied with that.
Melanie: Do you think that we should not worry about our weight quite as much and just worry about being healthy and getting that exercise and eating all of this good variety of foods?
Dr. Wells: Absolutely. Absolutely. Have a colorful plate, enjoy it, enjoy your exercise, enjoy your diet, enjoy your life. That’s the best medicine.
Melanie: So, give us your best advice in just the last minute here. For women and heart disease and stress and anxiety and all of these things that come together to contribute to heart disease being the leading cause of death among women in the United States and why they should come to UK Healthcare and the Women’s Heart Health Program for their care.
Dr. Wells: Oh, that’s a loaded question but I would start by saying know your numbers, have a risk assessment, eat and drink in moderation, exercise some everyday, have periodic assessment to determine what your risks are. Your risks change throughout your life. Stay on top of these. Most of all, enjoy every minute.
Melanie: That is great advice. For more information you can go to UKHealthcare.uky.edu. That’s UKHealthcare.uky.edu. You are listening to Advances and Insights with UK Healthcare in Lexington, Kentucky. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): Heart disease is the number one cause of death among women in the United States, more than lung cancer and breast cancer and all the other cancers combined. It causes 1 in 3 deaths each year but a major problem is that women aren’t diagnosed until they’ve had a major event and the symptoms that they experience are not the same as men. So, how do you know if you have heart disease? My guest today is Dr. Gretchen Wells. She’s a cardiologist specializing in women’s heart health at the University Of Kentucky Healthcare. Welcome to the show, Dr. Wells. Tells us about heart disease and how we women have different symptoms than men.
Dr. Gretchen Wells (Guest): Well, thank you for having me, Melanie. First, women sometimes do have the same symptoms as men: the chest pressure, the classic Hollywood heart attack, if you will. But, with women this can also be a bit more insidious. For example, we may present with some fatigue, shortness of breath, not thinking clearly, symptoms that we want to attribute to something else, just the daily stressors of life. But this can be very misleading and, as you pointed out, we don’t want to wait until it’s too late.
Melanie: So, most of the heart disease studies over the years have been done on men. Heart attack studies, all of those things, they were all done on men. So now, it’s sort of the tide is turning a little and we’re learning so much more about the difference in our women. Now, Dr. Wells, what symptoms do you want people pay attention to? Because, as you mentioned, some of those symptoms we women get could be from perimenopause, or menopause or stress, anxiety--things we all suffer from because we women are busy and we’re caregivers. So, what are those big red flags you want women to really pay attention to?
Dr. Wells: Anything out of the ordinary whether it is chest discomfort, shortness of breath, arm pain, jaw pain, anxiety--anything that is out of the ordinary should always be checked out. It’s great to provide a patient reassuring news and it’s even better to address a problem before it’s too late. So anything out of the ordinary, have it investigated. Maybe it is nothing. Or, maybe it is some psychological stress but we’re professional worrywarts in medicine. We don’t want to take any chances.
Melanie: Women tend to be professional worrywarts, too, and that causes some pains that mimic heart disease. So, what tests do you do so that we do find out?
Dr. Wells: We vary the testing for each patient. For example, if a woman comes in and has EKG changes, abnormal lab work, women go directly to a cardiac catheterization. Other times, if the EKG is normal and the symptoms occur with exertion, a stress test may be in order. There are different types of stress tests depending on the individual characteristics of the woman. Sometimes, she may not have symptoms at all and she wants a risk assessment. That is terrific to get on top of this before any symptoms even occur. Prevention. In that setting, we may do things--we’re not talking about high tech things here—something as simple as checking her blood pressure, finding out how much she exercises, checking her cholesterol, discovering how she copes with stress. Does she smoke, for example? Does she eat too much? Those are the type things that we investigate and we also have some more high tech resources available. MRI’s and so on are coming on the horizon and are terrific tools for investigating small blood vessel disease, if you will.
Melanie: So, what do you want women to know about stress, Dr. Wells, and its contribution to heart disease? Because we are all trying. We hear about managing our stress. Is there a link between stress and heart disease and what can we do about that?
Dr. Wells: Absolutely, there’s a link. We’re only beginning to recently find out more about it. Some stress, of course, is good. It’s what gets me out of bed in the morning but also learning how to cope with this, how to deal with this and coming up with some creative solutions. Daily exercise for example is a great way to alleviate stress and we know that women who exercise, just brisk walking, 30 minutes, five out of seven days a week, reduces your risk of a heart attack by 50%. That’s better than most medications that I can prescribe for you.
Melanie: Well, the American College Of Sports Medicine does say that exercise is medicine. So, how much exercise? Gives us your best prevention tips for heart disease
Dr. Wells: How much exercise? How long’s a piece of string here? But at a minimum I would say 30 minutes, five out of seven days a week. That is from the Nurses’ Health Study. This isn’t something I just pulled out of my head. Some other tips for avoiding heart disease? Stuff your mother always told you, for example. Well, one, of course, would be to pick the right parents. Unfortunately, this does run in some families, such as mine, but that’s an advantage because you know early on “I need to take measures to prevent this from happening.” But, in addition to daily exercise, avoiding tobacco products, keep you blood pressure under control, know your numbers, know your blood sugar, for example. We know our shoe size, we know our bra size and we should know things like our glucose, our blood pressure, our cholesterol and take measures to keep those within the guidelines.
Melanie: So, tell us what women can expect at the Women’s Heart Health Program at UK Healthcare, the Gill Heart Institute?
Dr. Wells: Well, first of all we have a personalized risk assessment program for each patient that walks through the door. We meet with the patient individually. We ask lots of questions. We are detectives. Then, we come up with what the best prevention and treatment strategy will be for that individual woman. So, no two women are alike who come through the door and we recognize that and treat that.
Melanie: What about the multidisciplinary approach? Because heart disease has so many facets to it both in treatment, after diagnosis and prevention, so where does nutrition and even some anxiety and stress management, where do they all play a role?
Dr. Wells: Absolutely, they do. We work closely with our colleagues in endocrinology in the treatment of risk factors such as diabetes, thyroid disease and so on. We work closely with our nutritionists, with sports medicine experts, with our nurse educators and we take a true, team-based, holistic approach. Women prefer that concept. I know I do. It’s been very effective.
Melanie: So, what does the role of nutrition play? What do you want women to know about diet and its contribution and/or aid in prevention for heart disease?
Dr. Wells: Well, you mentioned before that exercise is a medication. Food is, too. What I like to emphasize are a low fat. Well, I shouldn’t say “low fat” but the right kinds of fats. For example, peanuts, fatty fish and so on. Leafy green vegetables, the Mediterranean approach. It can be fun to go to the store and plan meals and they’re not only healthy but they’re good to eat, good for you and fun to plan.
Melanie: What about when we’re thinking of these foods and, of course, women, Dr. Wells, we’re always obsessed with our weight. What role does weight play in heart disease management?
Dr. Wells: Maintain an ideal body weight. We don’t want you too thin. Really, I prefer that the woman be healthy more than thin. We do obsess about our weight too much but as long as the woman is healthy and is within guidelines, I’m satisfied with that.
Melanie: Do you think that we should not worry about our weight quite as much and just worry about being healthy and getting that exercise and eating all of this good variety of foods?
Dr. Wells: Absolutely. Absolutely. Have a colorful plate, enjoy it, enjoy your exercise, enjoy your diet, enjoy your life. That’s the best medicine.
Melanie: So, give us your best advice in just the last minute here. For women and heart disease and stress and anxiety and all of these things that come together to contribute to heart disease being the leading cause of death among women in the United States and why they should come to UK Healthcare and the Women’s Heart Health Program for their care.
Dr. Wells: Oh, that’s a loaded question but I would start by saying know your numbers, have a risk assessment, eat and drink in moderation, exercise some everyday, have periodic assessment to determine what your risks are. Your risks change throughout your life. Stay on top of these. Most of all, enjoy every minute.
Melanie: That is great advice. For more information you can go to UKHealthcare.uky.edu. That’s UKHealthcare.uky.edu. You are listening to Advances and Insights with UK Healthcare in Lexington, Kentucky. This is Melanie Cole. Thanks so much for listening.