Hispanic, black women bear the brunt of cardiovascular disease

Mildred Rodriguez was 52 when she had a heart attack that changed her life. After undergoing open heart surgery, she vowed to take care of herself and to spread the message of prevention that women, particularly minority women, often ignore — to their detriment.

“Like many women, I thought, ‘That will never happen to me,’ ’’ recalls Rodriguez of northwest Miami-Dade, now 68 and retired. “I never paid attention. I never even knew I had any risk factors.’’

Unfortunately, cardiologists say, Rodriguez’s case is not unusual. Study after study finds that minority women’s awareness of heart disease and heart attack warning signs lags that of white women. A 2010 American Heart Association, for example, revealed that 60 percent of white women were aware of heart disease as the leading cause of death for women, but only 43 percent of African-American, 44 percent of Hispanic and 34 percent of Asian women correctly identified heart disease this way. These are especially worrisome numbers because Hispanic and black women have a higher risk for cardiovascular disease.

“We are doing our best to get the message out, but we still have a lot of work to do,’’ said Baptist Hospital cardiologist, Dr. Alvaro Gomez. “There are several reasons for this, but at least we know they can be addressed by educating the public.’’

Several public awareness campaigns have been launched in the past few years, but the information — essential to avert death and disability — is not spreading quickly or effectively enough in some communities. Some of the better known campaigns: The American Heart Association created Go Red For Women, an initiative designed to empower women to take charge of their heart health, about 10 years ago. And WomenHeart: The National Coalition for Women with Heart Disease was founded in 1999 by three women who had heart attacks while in their 40s and faced many obstacles, including misdiagnosis, inadequate treatment and social isolation.

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Getting the message out is essential. Almost 43 million women currently live with some form of cardiovascular disease. In fact, it is the number one killer of women — blamed for one in three deaths — and more women than men die of cardiovascular disease each year. After a heart attack, women are also 55 percent less likely than men to participate in cardiac rehabilitation, which improves recovery substantially,

Now the medical community is stepping up efforts to reach minority women, and for good reason. Hispanic women are more likely to develop heart disease 10 years earlier than non-Hispanic white women. And because of undiagnosed or poor control of high blood pressure, African-American women tend to bear a disproportionate burden of strokes and heart disease.

Minority women often have more risk factors for cardiovascular disease, too, and don’t know it. More are overweight. Eighty percent of African-American and 78 percent of Mexican-American women — the Hispanic subgroup most thoroughly studied — are overweight or obese, compared to 60 percent of non-Hispanic white women. What’s more, about 65 percent of black women and 62 percent of Hispanics do not meet Federal Physical Activity Guidelines, a much higher rate than for non-Hispanics white. Minority women also tend to have higher cholesterol and rates of diabetes. All these are risk factors for the disease.

“Our diets are not as healthy as they could be,’’ Gomez points out. “It’s all those sweets and complex carbohydrates.’’

There’s also a psychosocial component to minority women’s poor cardiovascular health, he adds. Minority women have less access to care. In some cases, income and language serve as barriers. Hispanic women are nearly three times as likely to be uninsured, too.

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“They’re also so worried about everybody else,’’ Gomez says, “that they don’t take care of themselves. When we see them, they’ve had these risk factors for a very long time.’’

Gomez and others suggest women “learn their numbers’’ — health numbers, that is. Blood pressure. Cholesterol. Sugar. “We have to worry about those and have them checked regularly just as women do with mammograms and Pap smears.’’

Dr. Olveen Carrasquillo, professor of medicine and public health sciences at the University of Miami’s Miller School of Medicine, believes there is actually good news in all this. “Exercise, diet, those kinds of things are modifiable. They can be controlled,’’ he explains, “but therein lies the challenge.’’

Just because something is good for us doesn’t mean we do it. “One of the obstacles we face is: How do you make long-term behavorial changes and how do you create a system to support those changes?’’ he asks.

While 90 percent of women have one or more risk factors for developing heart disease, more of those surveyed for a study were afraid of getting breast cancer than they were of heart disease, Carrasquillo points out.

Carrasquillo says it’s important to target the family — and the community — to ensure lifestyle changes that will lead to better cardiovascular health. “The family must see it as our issue, our problem,’’ he says. “We have to change the environment to help modify the lifestyle.’’

Dr. Viviana Navas, a cardiologist at Cleveland Clinic Florida, says that one of the first things she tells her patients is that “there is only so much I can do with medicine. Thirty to 40 percent is medication and the rest is up to you. So much has to do with a patient’s compliance and willingness to change.’’

It’s also tricky getting the word out to women on cardiovascular disease, particularly heart attacks, because “they present in a different way,’’ adds Navas. “Their symptoms can be atypical, much more than men.’’

Like men, women having a heart attack can feel a crushing or burning pain in the center of the chest, but they are more likely to experience shortness of breath, nausea/vomiting and back or jaw pain. Menopause is also a factor, as there is also an increase in heart attacks among women about 10 years after menopause. (Scientists believe a decline in estrogen may be a factor.)

After her scare, Rodriguez decided to do something about the lack of awareness and options for minority women, particularly Latinas. In 2010 she started the first WomenHeart Support Network for Spanish-speaking women in Miami. She now leads a free monthly support group, also in Spanish, that meets at Baptist and she travels the country speaking to other Hispanic-American group. As a result, she has become a familiar face — and voice — for Latinas living with heart disease. Her efforts were recently recognized by Baptist’s Miami Cardiac & Vascular Institute and at the 11th annual Woman’s Day Red Dress Awards in New York.

“This is my mission,’’ she says. “I feel we are saving lives little by little. Sometimes I think that maybe this was the reason for my heart attack: so I can go out there and tell others about it.’’

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