Women’s Heart Health Focus of Galentine Luncheon

By Misty Cryer

During American Heart Month, no topic could be better than heart health for women, presented by a professional in the community at the Women for a Better Carlsbad’s Galantine Luncheon on Valentine’s Day. Amidst the camaraderie of the group that meets quarterly, a heart-healthy lunch was served by the staff of Riverside Country Club, followed by informative presentations. The luncheon ended with giving gifts to attendees, with recipients chosen through a drawing.

Women for a Better Carlsbad was launched last fall by Therese Rodriguez, Kat Davis, Jennifer Watson, and Ekta Bhakta, also referred to as the “Core 4.” These ladies are passionate about the community of Carlsbad and seek to empower women to contribute to the mission to make Carlsbad an even better place. The organization connects like-minded women each quarter to learn about local initiatives, gain knowledge through educational talks, discover volunteer opportunities, stay updated on local events, and strengthen community partnerships.

At the Galentine Luncheon, Dr. Amanda Ryan, a local interventional cardiologist with Advanced Heart and Vascular Center of New Mexico, delivered a talk on women’s cardiovascular health titled “Take Her Health to Heart,” designed to promote equitable enrollment in clinical trials to improve cardiovascular health in women.

“It is kind of an interesting topic in a little different way to bring in that women have different symptoms regarding cardiovascular disease many times,” said Dr. Ryan. “We need to move beyond describing this disparity to increase female representation as part of cardiovascular clinical trials,” she said.

About disparities, Dr. Ryan said, they exist with women, with minorities, and they exist in rural areas. “We’ve got to become actionable,” she said, highlighting efforts to educate principal investigators of the main participation barriers for women and providing practical strategies to promote recruitment and retention of women in trials.

Dr. Ryan said that guidelines exist in the field of cardiology about evidence-based medicine to cover every diagnosis, noting that the subjects of these trials used in the development of guidelines are primarily Caucasian men, 50 to 70 years old, mostly from the East Coast. “That’s just the truth,” she said, pointing out that “we” are not very well represented.

In practice, Dr. Ryan said, the assumption that the trial findings are accurate for everyone is found not to be true. For example, she said, “Ace inhibitors like lisinopril or common blood pressure medication also used for heart failure, we found out somewhere along the way, they were not effective in African Americans at all. We figured that out by having a directed trial, just for African Americans regarding heart failure, and trying different drugs for them for heart failure and hypertension.” She said the African American community is notoriously suspicious of the industry and big pharma because of things that have happened in the past. “A lot of women feel the same way, and I think in our rural areas, there are just no principal investigators that are really involved in research.” These, she said, are all factors.

“Cardiovascular disease is the leading cause of death for women since 1900 in the United States. The truth is the number one reason women die one every 80 seconds continues to be heart disease. It affects 44 million women in the United States,” said Dr. Ryan. “Only 8% of primary care providers, 13% of GYN, and 17% of cardiologists are aware that heart disease is a greater cause of death in women than men,” she said.

“About 17% of cardiologists overall are women, although about 55% of current medical students and residents are women,” said Dr. Ryan, adding that women need to be encouraged. “Only about 4%, by the way, of interventional cardiologists are women.”

Dr. Ryan pointed out that women are vastly underrepresented in clinical trials, making up about 30%. She said women present older with heart disease and have more comorbidities, which she defined as “other things like diabetes, hypertension, and high cholesterol.” She continued, “We have different symptoms.”

“Fatigue and jaw pain are two major ones,” said Dr. Ryan about symptoms of heart attack in women. She asked, “How many middle-aged women have gotten really tired, are like, ‘Wow, I might be having a heart attack?’” This prompted laughter from the audience.

“I ask every woman who has acute heart attacks what did they feel like in the past before they had that acute event,” said Dr. Ryan. She said the fatigue was overwhelmingly a common symptom that was not recognized as a potential cardiac event. “That’s why we show up later.

“Another symptom of women and heart attacks can be just perfused sweating,” said Dr. Ryan, sharing that this symptom is often diagnosed as menopausal for women 50 to 55 years old, advising that we have a higher level of suspicion.

In encouraging women to take care of themselves before taking of others, she said, “If you gave a woman a list of symptoms, 92% of women would call 911 for their partner or somebody else that had those symptoms, but only 25% would call 911 for their self.”

Dr. Ryan pointed out that the patient has to feel comfortable with their physician and the importance of the physician listening to the patient. She encourages her patients to write down a list of questions so she can address them and meet their needs.

Dr. Ryan shared that there are chances to participate in studies, even when we are well, that might help ourselves and others down the road. She suggested approaching it with a healthy amount of suspicion if the opportunity arises. “There’s a lot of political changes going on right now, and there’s plenty of blame to go around for the current state of healthcare in America, but it is my opinion that it is in crisis, and we do have to do something different,” she said.

As a solution, she suggested trying to have research that we can trust with outcomes relevant to women, minorities, and people in rural areas.

In closing, Dr. Ryan said, “I think the idea is just to say that as a woman, be willing to get involved in some of these things, always advocate for your own health, and make sure you feel comfortable with your provider.”

Other presenters included Susan Crockett, who provided a New Mexico legislative update, and Angelia Parent, Zelma Lopez, and Charey Dunn, who shared information about the services of a non-profit in the community, Affirming Heart Victim Services. Jayce Rodriguez and his family were introduced, and he shared plans for opening a dermatology office in Carlsbad, Desert Bloom Dermatology.