Get the facts about heart disease from an Iowa City doctor

In an interview with the American Heart Association, Theresa M. H. Brennan, MD, Chief Medical Officer at UI Health Care in Iowa City and a strong supporter and sponsor of the Go Red For Women movement, separates fact from fiction.

MYTH 1. Heart disease is always genetic.

DR. BRENNAN: It's true that heart disease can be genetic, but often it is not. Cigarette smoking, diabetes, hypertension, obesity and hyperlipidemia are other factors that contribute significantly to heart disease risk.

In fact, cigarette smoking is the single most preventable cause of coronary artery disease or blockages in the arteries.

Diabetes has a very negative impact on women in accelerating heart disease and leading to a worse outcome in patients who have heart disease and diabetes. The important message here is that heart disease is preventable.

By managing blood pressure and cholesterol, eating right and losing weight if overweight, quitting smoking and increasing physical activity, women with these risk factors can greatly reduce their chance of developing heart disease by as much as 80%.

MYTH 2. Breast cancer is more deadly to women.

DR. BRENNAN: Heart disease greatly outweighs breast cancer risk. One in three women will die of heart disease, compared to one in 30 that will die from breast cancer. More woman die from heart disease than from the next four causes of death combined.

MYTH 3. Estrogen protects women from heart disease.

DR. BRENNAN: While estrogen is very beneficial in relieving menopausal symptoms, it may actually increase risk of heart attack in women.

Estrogens should not be prescribed to prevent heart disease in women. If you are having menopausal symptoms such as hot flashes, it is important to discuss your individual situation with your physician.

MYTH 4. My doctor will automatically perform heart-related checks at my annual checkup.

DR. BRENNAN: Unfortunately, heart disease risks are not an automatic part of the annual exam for all physicians. While physicians are very adept at ordering mammograms and Pap smears, evaluation of cholesterol, blood pressure, blood glucose and weight are not always measured.

Remind your physician to provide you with these numbers if they do not do this. It is very important to know your numbers. Women need to remind their physicians to discuss their individual heart disease risk factors and the symptoms that are associated with heart disease (as they may be different in women). The patient and physician need to develop a plan to evaluate for and provide early treatment for heart disease, similar to how mammograms and pap smears have become a routine part of preventive health strategies in women.

MYTH 5. I have to exercise at a gym for at least an hour to gain heart-health benefits.

DR. BRENNAN: The truth is any form of physical exercise is beneficial. This can include walking, swimming, jogging, bicycling, tennis and other forms of physical activity. It is recommended that women engage in at least 75 minutes of vigorous-intensity physical activity or 150 minutes of moderate-intensity physical activity every week. Many women find it helpful to have a workout buddy, to help you keep a regular schedule and accountable.

MYTH 6. Women have exactly the same symptoms as men.

DR. BRENNAN: The truth is women are more likely to experience unusual or atypical symptoms of heart disease including neck, jaw or arm pain, fatigue and shortness of breath with activity. Women, though, do present with typical symptoms of chest discomfort, so this should not be ignored. If a woman experiences symptoms such as these that are new and recur, she should see her physician and have an evaluation. If a woman develops arm, neck or chest discomfort that does not quickly resolve, she should call 9-1-1.

MYTH 7. If you have a clean EKG/stress test, nothing is wrong with your heart.

DR. BRENNAN: This is false. Women can have disease involving the small vessels of the heart that can result in chest pain and may not be picked up by an EKG or routine stress testing. If this is thought to be the case, your physician will emphasize the importance of treating all the standard heart disease risk factors and will likely encourage you to increase your physical activity. The higher the level of activity a woman achieves on a treadmill, the lower her risk of heart attack and death from heart disease.

MYTH 8. If you're young, you're safe from having a heart attack.

DR. BRENNAN: This is also false. Given the epidemic of obesity, diabetes, and inactivity, heart attacks do occur in younger women. The risk of dying after a heart attack is higher in women than it is in men. One problem with young women is that they are often perceived as not being at risk for heart disease; thus, their symptoms may often be discounted by healthcare providers.

That is why it is so important for a woman to know her numbers, her individual heart disease risk, and to recognize that symptoms of heart disease can be different in women. If a woman is concerned about heart disease symptoms and is not being taken seriously, she should definitely seek a second opinion and undergo appropriate testing.

Learn more about how to protect your heart at

www.GoRedForWomen.org.