Protecting Women’s Hearts

Heart disease doesn’t just attack overweight, middle-aged men with high cholesterol.

It kills about 450,000 American women each year—five times as many as breast cancer. And as Marla Cowan found out, heart disease can happen to women who are fit, thin and doing everything they’re supposed to be doing.

“I was taking my usual morning walk, when I felt a crushing pain, like a punch to my solar plexus,” says Cowan, who lives in Glenview. “I finished my walk and was getting ready to go to my pilates class, when it happened again.”

Cowan went to the hospital, where her symptoms were immediately recognized, and she had an angiogram, which indicated that three of her arteries were blocked; two were almost completely closed. She had triple bypass surgery and counts herself fortunate. Because she listened to her symptoms and received excellent medical care, she is still healthy and active.

But not every woman is that lucky.

According to the American Heart Association, women are 25 percent more likely to die in the first year after a heart attack when compared to men.

And no one is sure why.

Most of the studies doctors rely on were performed on men, and it’s only recently that women’s heart health is being researched. In 2009, the journal Heart published a study that showed women heart patients were less likely than men to be given beta blockers, statins or ACE inhibitors—they even got aspirin at lower rates than men.

Debbie Dunn knows first hand what many women experience. She had her first heart attack at age 45, and the tall, thin woman—who looks like the picture of health—was misdiagnosed by three different cardiologists.

“I felt alone and awful,” Dunn says. “The doctors weren’t listening to me, and I knew something was still wrong with me.”

For four months, the mother of three could barely get out of bed, but she pushed herself to take care of her children and continue her busy career. All the while, her doctors implied that her problems were mostly in her head.

Her luck changed when she found Annabelle Volgman, MD, director of the Heart Center for Women at Rush University Medical Center. In her first appointment, Volgman ordered follow-up tests that her previous doctors had skipped and saw that Dunn’s heart was functioning at only 30 percent capacity. She needed immediate surgery to implant a pacemaker/defibrillator and to save her life.

“If the care I received can happen on the North Shore of Chicago, imagine the care women in Oklahoma or Mississippi are receiving,” says Dunn, who lives in Libertyville. “This happened to me for a reason, and I believe it’s to educate women about heart disease and how to advocate for themselves.”

Both Dunn and Cowan found their way to WomenHeart, the country’s only advocacy and support group for women heart patients. The idea, similar to breast cancer support groups, is that no woman should have to struggle alone.

“My husband and friends were wonderful, but something was missing,” Cowan says . “I needed to talk to women who had been through the same thing.”

The movement is still young and growing. Even though heart disease affects hundreds of thousands more women than breast cancer, public awareness is lacking. But as more women step forward and tell their stories and urge their friends to take charge of their health, the perception that heart disease is a man’s disease will change.

“We want to empower women, not frighten them,” Cowan adds.

Her heart attack was the end of one part of her life, but the beginning of a new and better chapter.

“I believe it happened for a reason, and I believe I’m here for a reason.”

Looking to improve your heart health?
Write it down: Your family history is not your destiny. But you need to know what tendencies run in your family so your doctor can order the right tests and so you can take preventive measures now. We invite you to look to the February issue of Make It Better magazine for an easy-to-complete form. As you fill this chart out, you might not know your grandmother’s exact cholesterol numbers, but if she talked about having high cholesterol or if a relative took mediation for a condition; write it down.

Give a little blood, get a lot of heart
This important test for women with family history of heart disease could save your life

You can’t change your family’s history of heart disease, but once you know your risks, you can take action. A special blood test—polyacrylamide gradient gel electrophoresis—is especially important for women who have a family history of heart disease.

“This new test can determine the size of your LDL cholesterol particles,” says Annabelle Volgman, MD, the doctor who correctly diagnosed Debbie Dunn. “Women don’t know about this yet, but it’s extremely important even if your cholesterol level is normal.”

Blood cholesterol comes in two varieties: HDL and LDL. HDL is called the “good” cholesterol because it carries the cholesterol back to the liver. You want your HDL number to be above 50 mg/dl. LDL cholesterol is the one you want to lower, because it’s responsible for plaque on artery walls.

But complicating the scenario, scientists have discovered that LDL comes in two sizes. Pattern A LDLs are larger and less sticky. Dr. Volgman describes them as “big and fluffy.” Pattern Bs are small, dense and “stickier.” They clump in your arteries. Individuals with Pattern B LDLs are two to three times more likely to have coronary artery disease than individuals with Pattern A.

Most cholesterol tests only look at HDL/LDL ratios, not the particle size of the LDLs.

“It’s a more expensive test, so insurance companies don’t want to pay for it, but if you have a family history of heart disease, don’t wait,” Volgman says. “Insist on it because it’s important.”

If you have Pattern B particles, lifestyle changes and medication can make a difference. But you can only treat it if you know you have it.

Local Resources:

WomenHeart – for information on heart disease in women and local support groups, see their website at

Heart Center for Women at Rush University Medical Center at

National Resource:

American Heart Association – heart attack warning signs and information on cardiac health at


From the Heart: A Woman’s Guide to Living Well with Heart Disease
Kathy Kastan





Women Are Not Small Men: Life-Saving Strategies for Preventing and Healing Heart Disease in Women
Nieca Goldberg

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