It's Time For Gender Equality In Treatment Of Heart Disease

Women have made enormous strides. We've had women explore the depths of outer space, a woman has run for president of the United States, and a woman has served as speaker of the house. Yet a boys club still exists in the medical sciences.
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The following is drawn from a speech given at TedxWomen this year:


1) Heart disease kills more women than ALL cancers combined.

2) 4 percent of women are diagnosed with breast cancer annually, whereas 44 percent of women are diagnosed with heart disease.

3) Even though heart disease has been called a man's disease, since 1984, more women have died annually from heart disease than men.
4) In the United States, 39,520 women died of breast cancer last year but nearly 500,000 women died from heart disease. Put another way, in worldwide figures, 400,000 women die from breast cancer, but 8.6 MILLION women die from heart disease.

5) Given these statistics, only 24 percent of participants in all heart-related studies are women.

6) For 50 years, women have been treated based on diagnostics created for men.

7) And, surveys of available data show that a very small percentage of research dollars spent in the United States focus on the treatment of women with heart disease.


What's wrong with this picture is the outrageous gender inequality that women face in the treatment of heart disease.

I consider myself a well-informed person, but when I heard these facts, I was stunned. Very few people know this. And until recently, almost no one talked about or paid attention to an epidemic that women are dying from throughout the world.

Women have made enormous strides. We've had women explore the depths of outer space, a woman has run for president of the United States, and a woman has served as speaker of the house. Yet a boys club still exists in the medical sciences. When I learned this, I knew I had to get involved and try to do something to change this picture.

I believe that those with a platform in the entertainment industry have the privilege of being able to speak out against inequality, discrimination and injustice. That's why I have chosen to speak on this issue. The number of women dying from breast cancer has significantly declined over the years because of people speaking out, sharing their stories, and the enormous amount of money that is raised for research and early detection efforts. Last year an estimated 1.7 billion dollars was raised for breast cancer alone. A small fraction of that amount was raised for women's heart disease. We desperately need the same kind of coordinated campaign.

And so, in 2008, I endowed a research and education program at Cedars-Sinai's Women's Heart Center, under the leadership of Dr. Noel Bairey Merz, who is doing lifesaving work in this field.

Throughout my life, gender inequality has always concerned me, whether it's making a movie about it or becoming involved in women's issues. And in this case, gender really DOES matter when it comes to medical science. How can you treat a woman for a life-threatening ailment based on research done on men? Especially when women's hearts are physiologically different than men's hearts. Women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart -- a condition called microvascular disease.

Because of this, heart disease presents very differently in women than in men. 71 percent of women experience early warning signs of a heart attack with sudden onset of extreme weakness that feels like the flu -- often with no chest pain at all. Unlike the "Hollywood heart attack" we are all accustomed to seeing in movies and television where the man grips his chest and falls to the floor, most women who have a heart attack experience nausea and vomiting, sweating, and lightheadedness.

Nearly two-thirds of the deaths from heart attacks in women occur among those who have no history of chest pain. Most women do not know this and often times, by the time they enter the emergency room, their hearts have suffered substantial damage. Even if they go to their doctor, who is well intentioned, they are often misdiagnosed. I have met patients who have consulted 2 or 3 cardiologists and they are still misdiagnosed because many doctors are not given the proper training to know the warning signs in women.

Heart research done on women also helps men, as well. Take stem cell research, for example.

Recently, Dr. Merz and I were talking about the work of a colleague who is trying to grow the first human heart in a petri dish. She had a breakthrough in her study when she found out that using only female stem cells was the solution. She discovered that using male stem cells didn't work -- they got totally lost. And, as we know, men... even male stem cells... won't ask for directions.

Joking aside, the heart is an amazing organ, and first and foremost we need to focus on prevention. Women's lives are becoming increasingly demanding as they juggle the responsibilities of being wife, mother and helping to support the family. We need to take better care of ourselves. We need to slow down, reduce stress, eat better, make time to exercise... because the heart is a precious organ that needs to be protected.

Recently, I read an article authored by sociology professor, Mitch Hall. I found his insights, which are reinforced by various academic sources, really fascinating.

He wrote, "As we develop in utero, the human heart is the first organ to begin forming. In traditional Chinese medicine, the inner spiritual core of the self is deemed to reside, not in the head, but in the heart." He goes on to say, "The heart does not just pump -- what it does is listen." He suggests that the heart senses and integrates our thoughts, our emotions, and our will to carry out tasks. The heart actually is a sensitive integrator of all our experience.

Ancient cultures saw the heart as the seat of the soul. A human being has dual hearts -- the first a pulsating fist of muscle in the chest; the second, a precious cabal of communicating neurons that create feeling, longing, and love.

Many idioms attest to this 'second' heart, the social-emotional heart. For instance, sorrow is heartbreak. Sincere intentions are heartfelt. To be compassionate is to be openhearted, devoid of compassion -- heartless. To follow one's heart means to act on the basis of an intuitive sense of one's own most fulfilling option. He closes by saying, "to hearten is to encourage, and our English word courage is itself derived from the French word, coeur, meaning heart."

We can no longer afford to naively assume that heart disease is only a man's disease - because as I mentioned earlier, it's now an epidemic facing women. So I want to thank Dr. Merz for the work she is doing to help women live longer and healthier lives... women we love, our mothers, daughters, sisters, aunts, wives and friends.

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