After Traumatic Event, Women Face Increased Heart Disease Risk | HuffPost

Women May Face Increased Heart Disease Risk After Traumatic Event

LiveScience

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By: Sara G. Miller, Live Science Contributor
Published: 06/29/2015 08:18 PM EDT on LiveScience

Women who experience a traumatic event and develop post-traumatic stress disorder (PTSD) may be at increased risk for heart disease, a new large study suggests.

In the study, researchers found that women who had four or more symptoms of PTSD after a traumatic event had a 60 percent increased risk of cardiovascular disease, such as a heart attack or stroke, than women who experienced no trauma, over a 20-year period.

Women who had experienced traumatic events but who didn't report experiencing symptoms of PTSD had a 45 percent increased risk of cardiovascular disease, the study found.

"PTSD has often been conceptualized or thought of as just a psychological disorder," said Jennifer Sumner, the study's lead author and an epidemiology fellow at Columbia University's Mailman School of Public Health.

"What our findings suggest is that PTSD has effects that go beyond mental health, that also impact physical heath," Sumner told Live Science. [Top 10 Mysteries of the Mind]

PTSD, which affects nearly 8 million Americans yearly, is twice as common in women as it is in men, according to the National Center for PTSD. Symptoms include flashbacks of the trauma, insomnia and emotional numbness.

In the new study, published today (June 29) in the journal Circulation, the researchers collected data from nearly 50,000 women who were enrolled in a long-running study called the Nurses' Health Study II. Every two years for two decades, the participants indicated if they had experienced a heart attack or stroke (and the researchers confirmed these events by reviewing medical records). In the final year of the study, participants were also asked to complete a questionnaire that asked whether they had experienced trauma and PTSD symptoms.

The researchers also determined to what extent the women's health behaviors (such as smoking and lack of activity) and other medical conditions (such as high blood pressure) accounted for the link seen in the study between experiencing trauma and later having heart disease. In women who had experienced trauma and exhibited four or more symptoms of PTSD, the other factors accounted for about half of the association, the researchers found. This suggests that the link between PTSD and heart disease is not just physiological, but that health behaviors also play a substantial role, the researchers said.

"To our knowledge, this is the first study in women to … examine health behaviors and medical risk factors as potential mediators of the associations between trauma exposure, PTSD symptoms and CVD incidence," the researchers wrote.

Still, physiological factors also play a role in the association between PTSD and CVD. For example, research has shown that PTSD is associated with increased levels of inflammation in the body as well as elevations in blood pressure and heart rate,all of which are contributors to cardiovascular disease, said Donald Edmondson, an assistant professor of behavioral medicine at Columbia University, who was not involved with the new study.

It's unclear whether treating women's PTSD could improve their heart health, he said. "The question is, if we were to treat PTSD, will it improve the things that we know go along with PTSD?" Edmondson told Live Science.

The researchers intend to explore how intervention can offset the risk in future studies, Sumner said.

"It will be important to examine whether successful PTSD treatment has a positive impact on cardiovascular health," the researchers wrote.

The new findings suggest "the importance for looking at physical health in women with PTSD and having integrated physical as well as mental health care," Sumner said.

"Right now, the American Heart Association doesn't acknowledge stress or PTSD as an established risk factor for heart disease," said Sumner. "These findings, along with other work in the literature, suggest that it's an important factor to take into consideration," she said.

Follow Live Science @livescience, Facebook & Google+. Originally published on Live Science.

Copyright 2015 LiveScience, a Purch company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Before You Go

Women Who Changed Our Health

Clara Barton, Founder Of The Red Cross(01 of46)

Clara Barton (born 1821, and died 1912) is best known for being the founder of the American Red Cross. She also played a major role in caring for soldiers during the Civil War, where she nursed wounded soldiers and helped to search for missing soldiers, creating the Bureau of Records of Missing Men of the Armies of the United States, according to the Red Cross. Barton founded the American Red Cross -- initially called the American Association of the Red Cross -- in 1881, which has gone on to be a vital player in providing disaster relief around the country.-- ALC (credit:Alamy)

Virginia Apgar, M.D., Developer Of Apgar Score(02 of46)

Dr. Virginia Apgar, M.D., (born in 1909, and died in 1974) is best known for developing a standardized system to evaluate the health of babies when they are born. The system, called the Apgar score, was developed in 1952 before the era of fetal monitors and involved looking at the infant's breathing, skin color, muscle tone, reflexes and pulse, according to the March of Dimes.Apgar was also the first woman to earn the title of full professor at the College of Physicians and Surgeons at Columbia University, in the year 1949. She was also director of the division of anesthesia at Columbia, and it was during her time there that she studied specifically obstetrical anesthesia, the National Institutes of Health reported. Ultimately, Apgar went on to become director of the division of congenital effects at what is now the March of Dimes. -- Amanda L. Chan (credit:Getty Images)

Regina Benjamin, U.S. Surgeon General (03 of46)

Dr. Regina Benjamin, M.D., M.B.A., 56, was appointed by President Barack Obama to be the 18th U.S. Surgeon General. Prior to her appointment, Benjamin was an inspirational example of continuing on in the face of adversity -- the rural health clinic that she founded in Bayou La Batre, Ala., was destroyed multiple times by storms (including Hurricane Katrina) and a fire, but she managed to build it back up time and again, according to her official White House biography. Benjamin earned her medical degree from the University of Alabama and her business degree from Tulane University. She went on to become the first black woman under the age of 40 to become a member of the Board of Trustees of the American Medical Association. -- ALC (credit:Getty Images)

Elizabeth Blackwell, First Female M.D. (04 of46)

Today, close to half of medical school graduates are women -- but the first woman to earn an M.D. after her name was Dr. Elizabeth Blackwell, who achieved the milestone by graduating from New York's Geneva Medical College on Tuesday, January 23, 1849. Blackwell, who was born in England in 1821 and moved to the U.S. at age 11, also co-founded the New York Infirmary for Women and Children in 1857 and authored important books addressing women and medicine, including "Medicine As A Profession For Women" in 1860, according to her NIH bio.The NIH writes:

In her book Pioneer Work in Opening the Medical Profession to Women, published in 1895, Dr. Blackwell wrote that she was initially repelled by the idea of studying medicine. She said she had "hated everything connected with the body, and could not bear the sight of a medical book... My favourite studies were history and metaphysics, and the very thought of dwelling on the physical structure of the body and its various ailments filled me with disgust." Instead she went into teaching, then considered more suitable for a woman. She claimed that she turned to medicine after a close friend who was dying suggested she would have been spared her worst suffering if her physician had been a woman.

-- Laura Schocker (credit:Getty Images)

Rachel Carson, Biologist And Author(05 of46)

Scientist and writer Rachel Carson grew up on a 65-acre farm in rural Pennsylvania. She attended the Pennsylvania College for Women, where she started out as an English major, but then switched to biology, according to the U.S. Fish and Wildlife Service -- she later earned her master's degree in zoology from Johns Hopkins. But Carson found a way to combine both her love for English and science, as well as that early appreciation for nature, in her career, as she worked as a biologist while also publishing numerous pieces of writing for various publications. The New York Times reported in 2012:

Carson wrote within the crevices of a busy life, and often with serious health problems. In 1950, she had surgery to remove a tumor from her left breast. The next year, she published “The Sea Around Us,” a wide-ranging history of the ocean. It was an instant best seller. Readers responded to her graceful prose and marshaling of scientific facts, as well as to her long-term perspective. The book’s success enabled her to leave her position at the wildlife agency and devote herself to writing.

She published her iconic "Silent Spring" first as three serialized excerpts in The New Yorker in 1962, detailing the havoc wreaked on our environment by modern pesticides, which is credited with starting a movement toward the banning of DDT.-- MM (credit:Alamy)

Nancy Dickey, M.D., Former President Of American Medical Association(06 of46)

When Nancy Dickey, M.D. was elected president of the American Medical Association in 1997, she became the first woman to hold the esteemed role. Her career as a physician until then centered around family practice medicine, according to the National Library of Medicine.In office, she developed the Patient's Bill of Rights and "reshape[d] America's medical care," according to the Texas Women's Hall of Fame.She recently stepped down from her role as president of the Health Science Center at Texas A&M, where she was the first woman to hold that role as well.-- Sarah Klein (credit:Harry Cabluck / AP)

Selma Kaderman Dritz, Epidemiologist (07 of46)

Selma Kaderman Dritz was Assistant Director of San Francisco's Bureau of Communicable Disease Control, accustomed to food poisoning outbreaks and not much else, when young gay men began rapidly ailing -- dying from old fashioned communicable diseases and rare cancers. Hers was the first clear data delivered to the national Centers for Disease Control and Prevention, helping to shape the nation's understanding of the illness -- and its warning signs. As doctors began to deepen their understanding of the HIV virus and of AIDS, Dritz was on the frontline of prevention efforts. "We can't let those kids die," colleagues remember her saying regularly throughout the epidemic.-- MM (credit:Paris Match / Getty Images)

Gertrude Belle Elion, Chemist(08 of46)

Gertrude Belle Elion is responsible for many lifesaving drugs, but her greatest contribution may have been Purinethol -- the first major drug used to fight leukemia.Her career as a chemist was inspired by the death of her beloved grandfather from cancer. She vowed to find its cure and in her quest to do so developed 45 treatments that help the immune system overcome cancer, organ transplant and Herpes virus, among others. She won the Nobel Prize for Medicine in 1988. -- MM (credit:Karen Tam / AP)

Charlotte Ellertson, Founder Of Ibis Reproductive Health(09 of46)

Charlotte Ellertson, a sociologist and public health researcher, devoted her career to women's reproductive rights research and advocacy. After founding the non-profit Ibis Reproductive Health, Ellertson was instrumental in influencing the FDA to approve the RU-486 abortion-inducing pill. Although she died at 38 of breast cancer, her organization continues to do international reproductive behavior research and has been on the forefront of research on over-the-counter oral contraceptives, among other initiatives.-- MM (credit:Courtesy of Ibis Reproductive Health)

Wafaa El-Sadr, AIDS Researcher(10 of46)

Wafaa El-Sadr has spent her career on the underserved populations -- from the inner city to sub-Saharan Africa -- that require greater attention when it comes to preventing infectious disease. After 20 years developing family-focused and comprehensive services to prevent and treat HIV and tuberculosis as chief of the Division of Infectious Diseases at Harlem Hospital Center, El-Sadr moved on to the International Center for AIDS Care and Treatment Programs, known as ICAP. As head of ICAP, El-Sadr has helped an estimated 1,000,000 HIV patients to receive the services they need and has helped 500,000 patients access the anti-retroviral treatment they require. As the MacArthur committee, who awarded her a "Genius" grant in 2008, wrote: "Rather than focusing on proximal pathological processes, El-Sadr develops treatment strategies by considering such factors as access to health care, education, social status, and economic stressors."-- MM (credit:Getty Images)

Rosalind Franklin, Geneticist(11 of46)

When James Watson, Francis Crick and Maurice Wilkins received the Nobel Prize for discovering the shape of our genetic material -- the double-helix model of DNA -- the stage was lacking one woman: Rosalind Franklin, a colleague of Wilkins at King's College, who died prematurely and in obscurity a few years earlier. And yet it was Franklin's research on the structure of deoxyribonucleic acid that helped form the basis for the discovery. Early in her career, Franklin developed a method of diffracting x-rays that allowed her to capture living organisms. This ability helped her to take ever-more detailed photos of DNA fibers and make major strides in understanding their structure. In fact, her X-ray photographs of DNA -- which Wilkins showed to Frick and Watson allegedly without her permission -- were the inspiration for Watson's imagining of the double-helix structure. Although she was never given the acknowledgment she deserved in life (by all accounts, and in custom with the era's perception of female scientists, she was largely ignored by colleagues), she is now recognized as an essential investigator. -- MM

Jane Fonda, Actress And Fitness Advocate(12 of46)

The 1980s queen of fitness brought workouts to the living room. Fonda released her first exercise video, "The Jane Fonda Workout," in 1982, which sold 17 million copies and earned the distinction of the best selling home movie of all time, according to IMDB. "No one had ever done a fitness video before," she wrote on her website, JaneFonda.com, last year. "I remember writing the script on the floor of a hotel room during a Christmas skiing vacation in Calgary. It was spit and prayer, flying by the seat of our tights and leg warmers ... We rehearsed a few days, made some mistakes, did our own hair and makeup, had one camera and figured it was no big deal."Fonda, now 75, is also an Emmy and Oscar winning actress, as well as an activist, but she'll always have our hearts for 80s-style aerobics."What motivates me is how good I feel afterwards," she told CNN in 2012 about her fitness inspiration. "I don't wake up saying 'Oh goody, I am going to work out.' But I do it because of how it makes me feel when it's over. I feel so good. If I've felt depressed or down at all, it picks me up and makes me feel great."For a list of Jane Fonda's greatest workout moments, click here.-- LS (credit:Getty Images)

Helen Fisher, Physical Anthropologist(13 of46)

Romantic love may be one of the oldest human phenomena, but it is also on the cutting edge: understanding the chemical underpinnings and brain structure of our affections is Helen Fisher's life's work. Fisher studies patterns of lust and of love, as well as feelings of romantic rejection to help us understand the relationships that form the structure of our society: couplings, marriages, families and affairs. She completed the first ever brain imaging studies of those in the throes of romantic love and she is now at work on researching different personality types based on orientations to love, according to her website. -- MM (credit:Getty Images)

Ina May Gaskin, Midwife(14 of46)

The "most famous midwife in the world," Ina May Gaskin is held by many as the woman responsible for the revival of natural and home births. The 73 year old has herself assisted more than 1,200 births, started her own facility, the Farm Midwifery Center, and created the "Gaskin maneuver" -- the only widely-accepted birthing maneuver named for a midwife. In her acceptance speech of the 2011 Right Livelihood Award, she explained her discomfort with the shifting view of birth among obstetricians -- from a natural occurrence to a medical problem. "Birth shouldn’t be thought of as money-making commodity or condition in which large institutions or governments control and dictate how women will give birth, ignoring individual mother’s wishes and needs," she said. Inevitably, this too often puts bullies in charge of women’s bodies, something no other mammalian species allows."And in explaining her philosophy when it comes to birth, Gaskin revealed advice that applies to any number of medical circumstances, or simply, the endeavor of existing in one's human form: "Remember this, for it is as true as true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body."She will be inducted into the National Woman's Hall of Fame in October of this year. -- MM (credit:Getty Images)

Patricia S. Goldman-Rakic, Neuroscientist(15 of46)

Patricia S. Goldman, a renowned neuroscientist, was born April 22, 1937 in Salem, Mass. She received her bachelor's degree from Vassar College in 1959 and a doctorate from the University of California at Los Angeles in 1963. She went on to join Yale's faculty in 1979 after an impressive stint of research at facilities like UCLA, New York University, and the Massachusetts Institute of Technology and the National Institutes of HealthGoldman-Rakic's contributions to the study of the brain have immensely affected views on Alzheimer’s and Parkinson’s. She was the first researcher to fully chart the frontal lobe of the brain. Once thought to be inaccessible to scientific assessment, the frontal lobe affects personality, reasoning, planning, insight and more. Through electrical impulses, drugs, behavioral responses and other techniques, Goldman-Rakic was able to chart the frontal lobe."Pat Goldman-Rakic was one of the most distinguished neuroscientists of her generation. We grieve her tragic loss in the knowledge that her important contributions will live on," Yale President Richard C. Levin said after her 2003 death.In addition to her work with the frontal lobe, Goldman-Rakic went on to discover the significance of memory cells in the prefrontal cortex. In 1970 She found that the loss of dopamine in the prefrontal lobe led to the loss of memory. This study forever altered the face of neuropsychiatry by both demonstrating symptoms of mental illness and how psychoactive medications would affect patients.Goldman-Rakic's colleagues have praised her research, stating that her work on memory and behavior and drugs created a foundation for treating and grasping schizophrenia, Alzheimer's and Parkinson's disease. She passed away in 2003 from injuries sustained after being struck by a car.-- Lily Avnet (credit:Levitt P / Wikipedia)

Elizabeth Gould, Neurobiologist(16 of46)

Elizabeth Gould is a professor at Princeton University. Though her degree is in Psychology, she studies neurogenesis, the production of new neurons in the brain. She is considered to be an expert in her field of neuroplasticity.As a child she hoped to be an artist when she grew up, but happily discovered “a great deal of creativity in science.” Gould studies the production of new cells in the brains of mammalian adults and infants. In her laboratory she explores the hippocampus, olfactory bulbs and neocortex of rodents and primates in order to better understand the regulation of cell production.Gould received her B.A in psychology from Johns Hopkins University and then went on to study Behavioral Neuroscience at the University of California, Los Angeles. She has received numerous awards in her field.-- LA (credit:Princeton University)

Alice Hamilton, Industrial Toxicology Pioneer(17 of46)

The first woman appointed to the faculty of Harvard University in 1919, Alice Hamilton was a pioneer in toxicology during a time in which few people understood the connection between environmental pollutants and human health. Her work was some of the first that identified illness and injury as occupational hazards -- bringing "industrial medicine" (a common concept in Europe) to the United States. -- MM (credit:FPG / Archive Photos / Getty Images)

Nancy Miriam Hawley, Activist And Author(18 of46)

Nancy Miriam Hawley combined her feminism and political engagement with the simple fact for her and her friends' bodies: they were having babies or deciding not to have babies -- and they didn't have doctors who listened, she told the Jewish Women's Archive. So she and some like-minded women founded the Boston Women's Health Book Collective, Inc, developed a series of classes and lectures and then turned them into a book: the influential "Our Bodies, Ourselves."Hawley described the reaction:

The chapter on sexuality was the first chapter ever written by women for women about what it was like to be a sexual being. And of course that honest conversation threatened some people, and there were efforts to ban the book. Here we were, putting information out in the world, and people wanted to hide it away. But there was a groundswell of support for us, and we continued our work.

-- MM (credit:Bizuayehu Tesfaye / AP)

Jane Hodgson, M.D., Gynecologist (19 of46)

The only doctor ever convicted for performing an abortion, Dr. Jane Hodgson agreed to perform the procedure in order to challenge the law in her home state of Minnesota. Hodgson's conviction was suspended pending an appeal, according to her obituary, and overturned once the Supreme Court case, Roe V. Wade was heard. Hodgson lent her name to other abortion rights cases, including one in challenging a Minnesota state law that teenagers must notify a parent of an abortion procedure. -- MM (credit:Larry Salzman / AP)

Mia Hamm, Professional Soccer Player(20 of46)

Mia Hamm is on the (very) short list of household names when it comes to American soccer players. And rightfully so: Hamm played for the U.S. Women's National Team for 17 years, winning two world championships and two Olympic gold medals, before retiring in 2004, according to her website. In that time, she scored 158 goals in international games -- more than any other soccer player, male or female, in the history of the sport, Forbes reported.Hamm propelled women's soccer into the spotlight, attracting throngs of young female fans who dreamed of one day playing just like her. But her reach stretches far beyond the soccer pitch. Washington Post columnist Michael Wilbon called Hamm "perhaps the most important athlete of the last 15 years." CNN wrote, "Hamm is one of the most famous names in athletics." ESPN named her the best female athlete of the past 40 years, calling her "not just a winner but a legend -- and a symbol of what women's sports can be." The chairman of Nike has said there are three athletes "who just played at a level that added a new dimension to their games": Michael Jordan, Tiger Woods and Mia Hamm.We don't all become (or even want to become) professional athletes, but Hamm has without a doubt proven that we could. She continues to work toward more opportunities for girls and young women in sports through her non-profit, The Mia Hamm Foundation.-- SK (credit:Getty Images)

Barbara McClintock, Nobel Laureate (21 of46)

Barbara McClintock discovered the ability of genes to change places within the chromosome ("genetic transposition") and earned a Nobel Prize for it, making her the first American woman to win an unshared prize. -- MM (credit:Keystone / Getty Images)

Mary-Claire King, Geneticist And Breast Cancer Pioneer(22 of46)

During an era in which most scientists believed that breast cancer was caused by a random series of environmental and genetic factors, Mary-Claire King began to search for a genetic marker -- a particular gene that was common among women who suffered from the disease, finally zeroing in on chromosome 17. Her landmark research lay the groundwork for the discovery, in 1994, of the BRCA-1 gene, according to an MIT biography.-- MM (credit:NIH.gov)

Henrietta Lacks, Donor(23 of46)

Henrietta Lacks, a tobacco farmer from Southern Virginia, changed our health in a much less outright way than many of the pioneering women on our list. Lacks developed cervical cancer around age 30, and a scientist at Johns Hopkins Hospital in Baltimore used cells from her tumor to create the first immortal line of human cells to be used for future medical research, called the HeLa cells -- without telling her.Lacks succumbed to cancer in 1951, but HeLa cells went on to play an instrumental role in a number of monumental health discoveries and procedures, including developing the vaccine for polio, cloning and in vitro fertilization. Despite the fact that the cells have been "bought and sold by the billions," according to journalist Rebecca Skloot's recent book The Immortal Life of Henrietta Lacks, Lacks's family cannot afford health insurance today.The Henrietta Lacks Foundation "strives to provide financial assistance to needy individuals who have made important contributions to scientific research without their knowledge or consent," according to the Foundation's website, and a portion of the proceeds from Skloot's book are being donated to the Foundation.-- SK (credit:Wikipedia)

Evelyn Lauder, Breast Cancer Awareness Activist(24 of46)

Long before pink ribbons were a ubiquitous sign that October is upon us, Evelyn Lauder was a leader in the breast cancer awareness movement. The daughter-in-law of Estee Lauder, Evelyn, who worked in the Lauder family business, was diagnosed with breast cancer in 1989 -- she went on to found the Breast Cancer Research Foundation and create the pink ribbon as a symbol of awareness, along with Self magazine editor-in-chief Alexandra Penney, Women's Wear Daily reported in 2011.Evelyn Lauder died in November 2011 from complications of non-genetic ovarian cancer, according to her bio for the Breast Cancer Research Foundation. Former President Bill Clinton and former U.S. Secretary Of State Hillary Clinton said in a statement after her death, WWD reported:

Evelyn got the world closer to a time when no family will have to endure the pain of losing a mother, a wife, a sister, a daughter, or an aunt to this terrible disease. We will never forget how much she did to improve the lives of others.

-- LS (credit:Getty Images)

Susan Love, Surgeon And Breast Cancer Researcher(25 of46)

Growing up, Susan Love always wanted to be a doctor, and not just a doctor for women, but one who could perform all the same "macho" surgeries as men, she said in the recent documentary MAKERS.In 1980, she became the first female surgeon at Beth Israel Hospital in Boston, but, just as she'd feared, was given only female patients, mostly with breast problems. That's when she began to see, she said, that "what started as a career, really was going to be a mission."As one of the "founding mothers" of the breast cancer awareness movement, she's become an author, professor, member of the National Cancer Advisory Board under Bill Clinton and, above all, advocate. Her Dr. Susan Love Research Foundation began as an all-female group investigating "cutting edge" breast cancer treatments -- namely, lumpectomies and radiation. Today, the DSLRF has recruited thousands of women to participate in research studies that Love hopes will one day find the breast cancer cure."I think we can be the generation that stops breast cancer, and that's what drives me," she said in MAKERS.Temporarily on a leave of absence for treatment of her own leukemia, Love plans to return to continue as the President of the Dr. Susan Love Research Foundation soon.-- SK (credit:Getty Images)

Norma McCorvey, 'Jane Roe'(26 of46)

You may not have heard of Norma McCorvey, but you've certainly heard of her supreme court case, Roe v. Wade. McCorvey, better known as "Jane Roe," publicly acknowledged her role in the case that established abortion rights in 1980, according to the New York Times. Pregnant for the third time at the age of 21 and hoping to have an abortion in her home state of Texas, where the procedure was illegal unless the mother's life was endangered, McCorvey was introduced to lawyers Sarah Weddington and Linda Coffee. Proceedings lasted too long, however, and McCorvey gave birth and gave her third child up for adoption.After revealing her identity and publishing a memoir entitled "I Am Roe: My Life, Roe v. Wade, and Freedom of Choice", McCorvey worked in a number of abortion clinics and actively spoke out about her abortion-rights beliefs, CNN reported.While undoubtedly playing a large role in advancing women's rights and women's health, McCorvey has since changed her tune. "She started out staunchly pro-choice. She is now just as staunchly pro-life," Vanity Fair wrote in a 2013 profile. She began working for anti-abortion activist organization Operation Rescue and protesting against abortion, including at a Supreme Court hearing in 2009 where she was arrested.-- SK (credit:Getty Images)

Marion Nestle, Nutritionist (27 of46)

For many, proper nutrition is the first line of defense to foster good health. But it's always hard to know what to believe -- what's good advice and what's hype? That's where NYU nutrition professor and frequent pundit and author, Marion Nestle helps. On her website, Food Politics, Nestle interprets USDA regulations and offers informed opinions on studies, popular diets and trends. Michael Pollan and Mark Bittman, among other big names in food policy and culture consider her their go-to resource, making Nestle one of the most influential food thinkers of our time. -- MM (credit:Getty Images)

Florence Nightingale, Founder Of Modern Nursing(28 of46)

Credited with founding modern nursing, Florence Nightingale's parents were not pleased that a woman of her stature would dabble in something so unsuitable for upper-class life, according to the BBC. Eventually she won them over, leaving for Germany to train for three months before becoming superintendent of a London hospital in 1853. After the Crimean War began, Nightingale and a team of her nurses were sent to work in hospitals in Turkey where "she greatly improved the conditions and substantially reduced the mortality rate," according to the BBC. After returning to England, she established her own training school for nurses -- the first to be firmly based in the science of nursing, according to the Encyclopedia Brittanica. There, she established preliminary guidelines for medical matters, such as sanitation and hospital planning that continue on to this day. Today, to recognize her achievements, International Nurses Day is celebrated on May 12, her birthday.-- SK (credit:Alamy)

Antonia Novello, First Female U.S. Surgeon General(29 of46)

Dr. Novello was appointed to her groundbreaking position as the first female -- and first Hispanic -- surgeon general in 1990 by George Bush.She was inspired to become a doctor by a medical condition of her own that could only be corrected with surgery. However, her Puerto Rican family couldn't afford the procedure until she was 18, according to the National Library of Medicine.During her three years in office, she focused on health issues among women, minorities and children, as well as underage drinking, smoking and AIDS, according to the U.S. Department of Health & Human Servies.She is recognized for "changing the face of medicine" on the NLM's website.-- SK (credit:Scott Gries / Getty Images)

Lulu Hunt Peters, M.D., Columnist And Diet Book Author(30 of46)

In many ways, Lulu Hunt Peters is considered the mother of the American diet book. A doctor in an era with few female M.D.s, Peters worked as a hospital superintendent and wrote a health advice column for the Los Angeles Times. Her 1918 bestselling book, based on her column, "Diet & Health: With Key to the Calories" was the first to introduce American dieters to the concept of calories and counting calories as a method of weight loss. -- MM (credit:Corbis Images)

Ann Preston, First Female Medical School Dean(31 of46)

Before becoming the first female dean of a medical school -- the Woman's Medical College -- Preston delivered lectures to all-female classes with the simple intent of educating them about their own bodies, according to a profile from the National Institutes of Health. -- MM (credit:Wikimedia)

Anna O., Patient(32 of46)

The world's most famous case study, Bertha Pappenheim -- known as "Anna O." -- was a patient of Dr. Josef Breuer, who documented her strange and undiagnosable psychological condition with the help of his young associate, Dr. Sigmund Freud.Although Freud was skeptical of Anna O.'s actual illness (according to an account of the case in the Quarterly Medical Journal), the dynamic between patient and doctor helped to form Freud's talk therapy protocol. -- MM (credit:Getty Images)

Grethe Rask, Field Doctor(33 of46)

Margrethe P. Rask, a Danish surgeon who worked and lived in Congo during the 1970s, built several field hospitals and worked tirelessly for her patients, according to colleagues.Given field conditions at the time, gloves were not commonly used and needles were reused to save money, reported Randy Shilts in his book "And The Band Played On." By 1977, Rask was terminally ill. She is considered to be one of the first non-Africans to die from AIDS. -- MM (credit:Wikipedia)

Michelle Obama, First Lady (34 of46)

She dances "The Dougie." She hula hoops. She does a mean pull up. First Lady Michelle Obama, who launched the healthy living initiative Let's Move in 2010, is a true fitness inspiration. "The physical and emotional health of an entire generation and the economic health and security of our nation is at stake," she said at the Let's Move launch. The FLOTUS is actively working to ensure today's children grow up more active and with healthier food.And she practices what she preaches in the White House. "I never talked about weight in the household," she said in a "Fireside Hangout" on Google+ earlier in March, HuffPost reported at the time. "We just started making changes. And we made changes in a way that didn't make [Malia and Sasha] feel badly about themselves; it didn't even make them feel any ownership over it. Because truly, kids that age can't control what they eat. So as the mom, I took it upon myself to make sure that we just surrounded them with foods that were healthy and that they could eat whenever they wanted to. You just have to get the temptation out of the household wherever possible, and then just try to make activity fun."-- LS (credit:Getty Images)

Eleanor Roosevelt, Former First Lady(35 of46)

Eleanor Roosevelt transformed the role of the President's wife from one of a society hostess to a policymaker and public figure.But it was the former First Lady's work later in life -- after former Pres. Harry S. Truman appointed her to be the head of the U.N. Human Rights Commission in 1948 -- that made her stance on public health clear.As one of the primary authors of the Universal Declaration of Human Rights, Roosevelt made certain that access to health care was considered a fundamental right bestowed to all. -- MM (credit:Alamy)

Christiane Nusslein-Volhard(36 of46)

Nobel laurreate and director of the Max Planck Institute for Developmental Biology, Christiane Nusslein-Volhard has spent her life considering the developmental defects of fruit flies. As Smithsonian Magazine explained, her work "identified the key genes responsible for embryonic development in drosophila and amassed a detailed catalog of mutations that cause physiological defects -- insights that help scientists better understand human development."-- MM (credit:Joel Saget / AFP / Getty Images)

Florence Sabin(37 of46)

Sabin's natural skill and innovation as a medical student at Johns Hopkins School of Medicine later earned her a spot as a professor of embryology. Her study of the fetal brain stem and embryonic lymphatic system helped form text books on the subject, according to a biography from the National Institutes of Health. In her later career, Sabin became a member of the Rockefeller Institute and was was instrumental in understanding tuberculosis. "I hope my studies may be an encouragement to other women, especially to young women, to devote their lives to the larger interests of the mind," Sabin stated in a 1929 acceptance speech. "It matters little whether men or women have the more brains; all we women need to do to exert our proper influence is just to use all the brains we have."Among her many accomplishments, Sabin was also the first woman elected to the National Academy of Sciences. -- MM (credit:Getty Images)

Margaret Sanger, Reproductive Rights Activist(38 of46)

As a young nurse amid the tenements on Manhattan's Lower East Side, Margaret Sanger spent much of her time caring for young women who had suffered from botched abortions. She watched her own mother die young after giving birth to eight children. And then she vowed to do something about it: Sanger was the mastermind behind Enovid, the first FDA-approved oral contraceptive, and founded the American Birth Control League -- now known as Planned Parenthood. Born into a world without legal contraception or abortion services, Sanger devoted her life to her strongly held conviction that the way out of poverty, the way to freedom, was through reproductive control. -- MM (credit:Alamy)

Helen B. Taussig, M.D., Pediatric Cardiologist (39 of46)

Dr. Helen B. Taussig is considered the founder of pediatric cardiology and co-developed the "blue baby operation," a procedure that corrects the congenital heart defect that causes anoxemia or "blue baby syndrome." In doing so, she has saved countless lives in their earliest stages. -- MM (credit:William A. Smith / AP)

Rosalyn Sussman Yalow, Geneticist(40 of46)

Anyone who has required a blood transfusion has Rosalyn Sussman Yalow to thank. Her work to develop the radioimmunoassay technique made it possible to screen blood donations for infectious diseases like hepatitis. The technique earned her a Nobel Prize in 1977. -- MM (credit:Keystone / Getty Images)

Kathrine Switzer, First Female Marathoner (41 of46)

In 1967, when Kathrine Switzer became the first woman to officially enter the Boston Marathon, no woman had done so for 70 years. Under the name K.V. Switzer, the 19-year-old Syracuse University journalism major was able to enter the event unknown to race officials, until race director Jock Semple caught wind there was a woman running. After jumping from the press truck into the field of runners, Semple attempted to remove Switzer -- forcibly -- from the race, when her boyfriend Tom Miller shoved him out of the way.She finished the race in four hours and 20 minutes, but it wasn't until she saw her photo in newspapers that she felt the marathon would truly change her life, she said in the recent documentary MAKERS. Women were finally allowed to compete in the Boston Marathon in 1972. Switzer went on to win the 1974 New York City marathon, and later set her personal record (2:51) in Boston in 1975, before turning her attention to campaigning for the women's marathon to be added to the Olympics.She's left her mark on women's running, for the casual jogger and Olympic medal winner alike."I met her when I ran Boston the first time in 2009," Olympic distance runner Kara Goucher told ESPN. "It is fair to say that her courage to run the Boston Marathon paved the way for me to live the life that I do. Thanks to her bravery, I am living my dreams and running professionally."Switzer, now 66, ran the Berlin marathon in 2011 in four hours and 36 minutes, a time fast enough for her age to still qualify her for Boston. She plans to run in Boston in 2017, to mark the 50th anniversary of her historic race, according to her website.-- SK (credit:Alamy)

Sherry Turkle, Psychologist(42 of46)

For more than 30 years, psychologist and MIT professor Dr. Sherry Turkle has studied the psychology of digital interaction. Dubbed "the Margaret Mead of digital cuture," Turkle warns of the psychological and social downfall of accepting computer and technology-based interactions. “We're lonely, but we're afraid of intimacy," said Turkle. "And so from social networks to sociable robots, we're designing technologies that will give us the illusion of companionship without the demands of friendship.”-- MM (credit:Getty Images)

Lydia Villa-Komaroff, Molecular Biologist(43 of46)

Lydia Villa-Komaroff knew she wanted to be a scientist from early childhood, even though she knew of no other female Latina professional scientists, she told MAKERS. In fact, she's the third Mexican-American woman ever to receive a science Ph.D. -- hers in molecular biology from MIT. Despite Harvard's ban on recombinant DNA research (which was considered dangerous at the time), Villa-Komaroff was able to make a name for herself as a researcher in this area: Her discovery of how to generate insulin from bacterial cells earned her two patents and the accolades of colleagues. Since that time, Villa-Komaroff has chaired committees for the National Institutes of Health and has advised the first ever federally-funded brain-transplant studies. -- MM (credit:Alamy)

Dr. Ruth, Sex Educator(44 of46)

Once described as a "cross between Henry Kissinger and Minnie Mouse" for her trademark accent, Ruth Westheimer -- better known as Dr. Ruth -- is a psychosexual therapist and media personality who paved the way for open, frank dialogue about sex on public media outlets.Dr. Ruth's ultimate breakthrough came in the early 1980s, with her pioneering television and radio show, Sexually Speaking, on which she answered call-in questions from listeners. “Talking about sex on TV was considered very daring. But when I talk about sex it's not to shock, but to educate,” Westheimer says. The show’s instant success makes the case that Dr. Ruth was giving Americans exactly what they needed: Honesty. The tiny (she’s four feet, seven inches), German-born therapist has quite a multifaceted resume: After fleeing to Switzerland to escape the Holocaust, she trained for the Israeli freedom fighters as a scout and sniper, after which she moved to Paris to study psychology at the Sorbonne. It was in the 1960s, in Harlem, N.Y., where Westheimer’s work with Planned Parenthood led her to study sexuality. Here she began to advocate for sex education and break the silence surrounding taboo topics, like contraception and unwanted pregnancies. Today, at 84 years old, Dr. Ruth serves as the Honorary President of the Council of Sexuality and Agiting at the Naional Sexuality Resource Center and is still answering our sex questions on her own YouTube channel and Twitter account. We can thank Dr. Ruth for making sexual literacy mainstream, authoring more than 30 books (and counting) and one of her most celebrated tag phrases, “Get some.”-- KB (credit:Getty Images)

Sarah Weddington, Lawyer(45 of46)

Growing up as a preacher's daughter always made her feel different, Sarah Weddington said in the recent documentary MAKERS. So going to law school and running for state legislature -- when women "didn't do" those things -- was just more of the same for the Texan. But while at law school, she was approached by a women's group that wanted to legalize abortion. She was just 26 years old when Roe v. Wade was selected to be argued before the Supreme Court. "I was very conscious of how the fate of many women for many years would be resting in part on my argument," she said in MAKERS.The landmark 1973 ruling overturned laws in 46 states, handing over the decision to terminate a pregnancy during the first three months to women and their doctors, rather than the government. Since then, Weddington worked as a professor at the University of Texas, as one of Jimmy Carter's advisers and as an advocate for breast cancer research, after surviving the disease herself, HuffPost reported.More than 40 years later, she said she never would have believed we'd still be talking about abortion. However, her stance remains the same. “It's the argument where 40 years ago, I was saying, 'We are not asking this court to decide that abortion is good, or that everyone should have one. We are asking this court to decide that that issue is one for the individual to decide, not the government.' And it’s the same thing that I would say today," she told Time magazine.-- SK (credit:Getty Images)

Nancy Wexler, Hereditary Disease Researcher (46 of46)

Geneticist and Higgins Professor of Neuropsychology at Columbia University, Nancy Wexler, Ph.D. is most well-known for her research surrounding Huntington's Disease, a genetic condition that causes parts of the brain degenerate. Wexler's study of the world's largest family with the disease has led to identifying the gene responsible for Huntington's. Blood samples from the 18,000-plus individuals involved in her research have also helped researchers investigating Alzheimer's disease, kidney cancer, ALS and more. She also serves as president of the Hereditary Disease Foundation, which works toward cures for genetic illnesses by funding continuing biomedical research, according to the organization's website.-- SK (credit:Getty Images)

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