At the Heart of Patient Care

More than 90 percent of women have at least one risk factor for heart disease, yet most women are unaware that heart disease is their leading cause of death in the United States.  Less than half (39%) of primary care physicians, including ob-gyns, consider cardiovascular disease to be a top concern for women.

Last month, ACOG and the American Health Association released a joint advisory calling on ob-gyns to use annual well woman exams as an opportunity to assess a woman’s risk for heart disease.  For many women, their ob-gyn is the only physician they see routinely, particularly women during their childbearing years. This emphasizes the important role of the ob-gyn to identify risk factors for heart disease and stroke—long before clinical signs are apparent.  Not doing so is a missed opportunity for early detection and intervention.

Research shows that pregnant women with complications like preeclampsia, gestational diabetes, and growth restricted babies, have three times the risk of later cardiovascular disease than women without these pregnancy complications.  Additionally, cardiovascular events and cardiomyopathy are the leading causes of maternal mortality in the U.S., together accounting for 25 percent of all maternal deaths.

As the leading health care providers for women, we can be a powerful voice for patients, counseling and educating them on how to achieve and maintain long-term heart health. Whether it’s advising patients about healthy diet and lifestyle, or taking advantage of high-tech solutions such as software algorithms that can trigger patient education and referrals by analyzing data contained in electronic medical records, the well woman exam is an opportunity for us to deliver patient-centered care.

I’m so excited to share more with you during my year in office, and to hear from you directly. Connect with me on twitter at @TXmommydoc.

Ob-Gyns Can Be the Secret Weapon in the Fight Against Heart Disease

As ob-gyns, we know that the care we provide to women goes far beyond reproductive health. Thirty-five percent of women consider their ob-gyn their sole health care provider, putting us in a unique position to address an array of common health conditions. Since heart disease is the number one killer of women—and February is Heart Health Month—now is a good time to remember the part we can play in changing the outcomes of this devastating disease.

Perhaps the biggest threat of heart disease is lack of awareness of the condition’s prevalence and dangers. Though heart disease causes one in three deaths among American women every year—and 90 percent of women have at least one risk factor for developing heart disease—only one in five believes that heart disease is her greatest health threat, according to the American Heart Association (AHA). Equipped with these statistics, ob-gyns should feel confident initiating a conversation with patients about their heart health.

Helping patients address heart disease risk factors, ideally before a heart disease diagnosis, is key. Nearly two-thirds of women who die suddenly of coronary heart disease have no previous symptoms, according to the Centers for Disease Control and Prevention. For many women, the first signs of heart disease are actually the symptoms of a stroke, heart failure or heart attack, when serious damage may have already occurred. However, a number of risk factors are mostly under a patient’s control: an unhealthy diet and/or lack of exercise (both of which can lead to other important risk factors, including being overweight and having high blood pressure, high LDL cholesterol, and diabetes); smoking; and drinking to excess. When women are educated about how to make important lifestyle changes, it can be lifesaving. According to the AHA, 330 fewer women are dying from heart disease every day as a result of making heart healthy choices.

There are some factors that are out of a patient’s control, including a family history of heart disease, preterm labor and delivery, and preeclampsia. Ob-gyns can play an essential role by communicating the steps women can take to reduce their odds of a heart disease diagnosis. Even by simply acknowledging and discussing the risks, ob-gyns can make a difference. So, while these conversations aren’t always comfortable, they’re important because many women may not be hearing this information from any other health provider.

Lastly, since the symptoms of heart disease are widely misunderstood, particularly in women, it’s critical to share them with at-risk women. While angina is the most common symptom associated with heart disease, women are actually more likely to experience pain in the neck, jaw, throat, abdomen or back; shortness of breath; and nausea/vomiting. Lightheadedness, dizziness or fainting are common signs, as well. These symptoms don’t always occur during exercise or periods of stress; they can happen during rest, too. By ensuring your at-risk patients are aware of these signs, it could mean they get treatment faster, which will ultimately lead to better outcomes.

Ob-gyns have a powerful opportunity to be the secret weapon in the fight against heart disease. We can help inform our patients about the dangers, symptoms, and necessary preventative care. Communicated early and effectively, we can help women manage the factors that are in their control to help them live healthier, longer lives.