Dr. Sandy Charles is the medical director of Novant Health’s Women's Heart & Vascular Center in Charlotte. She’s a passionate advocate for heart health for everyone, but she is especially focused on the heart health of women.

Heart disease is the leading killer of American women – a fact that usually takes people by surprise. Many incorrectly assume that breast cancer is the No. 1 killer.

But heart disease kills more women than all forms of cancer combined. Breast cancer kills 1 in 39 women; heart disease kills 1 in 5.  

My interest in cardiology comes from a deeply personal place. As a child, I watched my grandmother suffer from cardiovascular disease. She had high blood pressure and diabetes – two big risk factors – and her doctor never communicated why these risk factors were so dangerous if they remained poorly controlled.

She passed away at a younger age than she should have from a variety of cardiovascular complications. I now make it my mission to provide people with as much information as possible to empower them. Here are a few things about heart health I think everyone should know.

  • About 80% of heart disease is preventable. There’s so much that’s beyond our control, but heart health is mostly within our control. Even small lifestyle modifications can lead to significant results.
  • Heart attack symptoms can differ for men and women. Men having heart attacks typically present with chest pain. Some women have chest pain, too, but they may also have indigestion, fatigue or difficulty breathing when having a heart attack.
  • Black women, in particular, have a high risk of heart disease. More than 50% of Black women aged 20 or older have high blood pressure. That puts us at greater risk for heart disease. There are many theories as to why that’s so. It could be genetic. It may also be due to increased consumption of high-sodium foods and physical inactivity.
  • The first symptom of heart disease is sometimes death. That’s the scariest thing about heart disease. Sudden cardiac death can be the first manifestation that something is wrong. Sometimes there’s no second chance.
  • High blood pressure, high cholesterol and a family history of heart disease are among risk factors.
  • Obesity is another prominent risk factor for heart disease. So, it’s important to know your body mass index (BMI). If it’s too high, take steps to lower it.
  • Diabetes is a big risk factor. Patients diagnosed with diabetes are assumed to already have plaque buildup in their hearts. And women with diabetes are at greater risk for heart disease than men.

While heart disease is very common and incredibly serious, I try to emphasize the good news. People have the power within themselves to change, improve and maintain their heart health.

What can you do?

  • Be your own advocate. Heart disease can go untreated or undertreated in women, and I think there can sometimes be an underlying bias. Doctors may not suspect you could have heart disease if you are young and “look” healthy.

I encourage women to advocate for themselves. Really persist. Women have come to me for second opinions who have symptoms atypical for heart disease and have been told it's “probably just stress.” Some are even prescribed medications for stress.

  • Pay attention to nutrition. Simply knowing about the foods you're putting in your body is important. A lot of the sugary drinks people consume have even more sugar than you might imagine. For example, a 20-ounce glass of soda can have 65 grams of sugar, the same amount of sugar as more than dozen chocolate chip cookies (depending on the cookie).

Processed foods and a lot of restaurant foods have massive amounts of sodium. A lot of the sandwiches we get at delis or fast-food places contain, in one serving, more than your whole daily recommended salt limit. Aim to eat whole foods, whole grains, brown rice, lots of veggies and fruits.

  • Get moving. Exercise is incredibly important. Try for at least 30 minutes a day, five days a week. When my patients say they don't have time to fit it in, I always say: Nothing is more important than your health. If you’re currently not exercising, start small. Walk around the block. Walk in place while you’re on a phone call. Anything is better than nothing.
  • Care for body, mind and soul. Mental and emotional health are connected to heart health. We are living in really stressful times, and women are frequently wearing the Superwoman cape and doing too many things at once. COVID-19 has made things a lot worse on that front. These times can make us anxious, depressed, sleepless. All these things factor into heart health.

When people are depressed, they may drink more, and that's dangerous for heart health.  Minimizing alcohol intake can improve overall health.

  • If you're having any cardiac symptoms, get treated. Too many people are scared to seek medical attention now – because of COVID-19 – even when they have symptoms. Over the past few months, the number of people who come to the hospital with heart attacks has declined by a lot. So, more people are suffering and dying from heart attacks at home instead of seeking help. Bottom line: Do not be afraid to seek medical attention if you develop concerning symptoms. The sooner you seek care, the better!

Nobody is immune to heart disease. But you can reduce your risk of getting it. It’s even possible to reverse any damage already done by taking control of your health. Eat whole foods, exercise and get routine checkups. It’ll do your heart – and your body – good.

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