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Barbra Streisand

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Why Heart Disease Is Treated Like a Boys' Club

Posted: 11/15/10 02:32 PM ET

Women have broken through some of the hardest glass ceilings. We've had women explore the depths of outer space, a woman run for President of the United States, and we've had a woman serving as Speaker of the House, a position that is just two heartbeats away from the Presidency. Many consider politics as one of the last bastions of the boys club and thankfully -- although slowly -- women are finally making real inroads.

But there is another boys club that until recently many people either didn't know about or talk about. It came as a big shock to me to discover that gender inequality still prevails in the medical sciences when it comes to research and treatment of some illnesses. I consider myself a well-informed person, but I only became aware of this fact when learning about women and heart disease, and I was stunned.

Heart disease is the number one killer of women in our country, more than all cancers combined. Today, heart disease kills more women than men. When I started to think about this, it was not surprising. More women are taking on the stresses of juggling household demands, of being wife, mother and breadwinner. All of these modern day strains add to higher blood pressure, lack of physical activity, quick and unhealthy food choices, and weight gain -- all major contributors to heart disease.

Despite the statistics, for years, most of the medical community has been treating our mothers, wives, daughters, sisters and friends inadequately because they based their treatment protocols on research outcomes done mostly on male patients. Cardiologists treating women certainly intended to provide their patients with quality care, but they could only depend on the research that was available and known to them.

In 1991, Dr. Bernadine Healy, the first woman director of the US National Institute of Health, studied the gender bias in the treatment of coronary heart disease. Termed the Yentl syndrome (a surprising coincidence), the study revealed that "once a woman showed that she was just like a man by having severe coronary artery disease, she was then treated as a man would be." This would make sense if women's hearts were biologically the same as men's hearts -- but they aren't! And because of the biological differences, heart attacks present differently in women than they do in men. Instead of the classic attack -- clutching a painful chest -- women often have indigestion and fatigue. Plus, women are more likely than men to develop micro-vascular disease, which affects the heart's smallest arteries.

We can no longer afford to naively assume that this is only a man's disease -- it's now a woman's epidemic. We may be almost 50 years behind in our research knowledge that informs diagnosis and treatment regimens for women with heart disease, but we are finally starting to close that gap. The Women's Heart Center at Cedars Sinai Medical Institute is helping to lead the way in this effort as one of few institutions in the country on the cutting edge of this research. The Center is led by Dr. Noel Bairey Merz, a Harvard Medical School graduate. Dr. Merz has published over 180 scientific publications and more than 200 abstracts and has received numerous awards recognizing her as one of the field's leading experts on preventive cardiology, women's heart disease and mental stress. It was clear to me that I had to get involved when I heard that this brilliant woman was doing lifesaving work that would ultimately impact women all over the world -- right in my own backyard!

But it's all of our responsibilities to be advocates on this issue and to demand that gender inequality, especially when it comes to life and death issues, is not acceptable. This is a call to action and I hope you all will join me in supporting the new and vital work that is being done on women's heart health. If you want to learn more, visit: CrowdRise.com/barbrastreisand

 
Women have broken through some of the hardest glass ceilings. We've had women explore the depths of outer space, a woman run for President of the United States, and we've had a woman serving as Speake...
Women have broken through some of the hardest glass ceilings. We've had women explore the depths of outer space, a woman run for President of the United States, and we've had a woman serving as Speake...
 
 
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06:30 PM on 01/03/2011
Barbra may be shocked at the fact that women's heart disease kills more women than all cancers combined. I am shocked that research is done on men for a disease that affects women differently. That's almost like a woman going to a doctor who specializes in penile disorders. WTF???? Thanks, BJ, for starting the research center at Cedars-Sinai out of your own pocket. I wonder what the folks over at Fox Noise can say about you now. But I'm sure they'll find something to criticize you about. Screw 'em.
02:01 PM on 11/23/2010
Thank you Ms. Streisand for sharing your reaction to the gross inequities in women’s heart disease. Unfortunately, heart disease is not the only condition that affects women disproportionately or differently from men.

Before 1990, women were not included in medical research and clinical trials, and to almost everyone women’s health meant reproductive health. After the establishment of the Society for Women’s Health Research (SWHR) in 1990 and legislation that required the inclusion of women in research studies, we have learned that biological sex must be considered in all phases of medical research and in clinical care.

For example, women may have different symptoms when experiencing a heart attack and women are more likely than men to have a second heart attack within a year of the first one. Lung cancer, autoimmune disorders, drug and alcohol addiction, osteoporosis, pain conditions, stroke, and depression are but a few of the conditions that effect women differently; and the differences influence the methods of prevention and diagnosis, the symptoms and the treatment options.

SWHR advocates for greater research into sex differences and increasing the number of women and minorities in clinical trials to better treat these debilitating diseases

With the help of celebrities such as Barbara Streisand more people will become aware of the inequities in medical research and health care and support increased funding for sex differences research. For more information on biological differences that affect our health, please visit swhr.org.
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SeaBlood
cynical about religion
07:35 PM on 11/21/2010
So you are saying that we need more gender equality by introducing gender inequality.
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HUFFPOST SUPER USER
Philly219
06:49 AM on 11/22/2010
No, what she is saying is medical research is needed in the area of female cardiology. Its not a matter of ignoring men's health, its a matter of coming up to date on womens.
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Berlusca
09:53 AM on 11/21/2010
It's an enormously important issue reflecting broader, equally important and as yet sticky, structurally biased research. Lack of gender distinguishing remains a systematic defect which has and is still slowing the advancement of understanding, modeling and eventual resultant therapy, policy or treatment of many things - for everyone. Keep insisting, particularly to physicians.
03:44 AM on 11/21/2010
I was so pleased to read this post.

Women present differently than men when they have a heart attack. The medical community is just now beginning to run diagnostic tests to rule out a heart attack in women when they go to the ED.

I am not sure if they have done this yet but when i worked the angioplasty unit, women never did as well as men. The reason was because the equipment wasn't designed for a woman's anatomy.

Women have smaller blood vessels, their stature is smaller than a man so the vessels are shorter.

Aspirin from what I have read is ineffective in preventing heart attacks in women.

The best thing a woman can do is to be informed and proactive, demand blood work to rule out a heart attack. Exercise, keep a healthy weight, find healthy ways to deal with stress.
09:30 AM on 11/20/2010
We just have to keep on educating. --Breaking the stigma.
09:36 PM on 11/17/2010
Once again I come across women having to "juggle" responsibilities both domestic and occupational. I'm STILL waiting for an explanation of why I've never come across men having to do likewise. In my personal life, male and female both are responsible for any necessary "juggling".
02:48 PM on 11/17/2010
Thank you Barbra. Again this ads to my theory that if it happens to men then it will be studied or cured much faster. As long as we have old white males as the majority in congress, we will be put on the back burners all the time. We all have seen how time and money for mens impotency ( viagra) was more important then Womens health issues. Well there is the saying that if men could get pregnant by incest and rape, there would be an abortion clinic on every corner!
01:52 PM on 11/17/2010
This is an extremely important issue, and I'm glad to see it is finally getting the attention it deserves. As you mentioned, women today face incredible amounts of stress in their daily lives, and this constant anxiety and worry is literally making them sick. When treating patients who suffer from high levels of stress, I recommend a simple guided imagery technique called Stressbuster Imagery: http://worrysolution.com/2010/09/02/the-easiest-way-i-know-to-relax/. It can be done anytime, anywhere in a matter of minutes, and it has dramatic beneficial results for overall health.
01:21 PM on 11/17/2010
We applaud Ms. Streisand for adding her voice to the cause of health equity for women. Women's Health Reserach at Yale is in its 13th year of initiating interdisciplinary research studying gender differences, not only in heart disease, but in the broad range of conditions that are more prevalent in women or result in greater morbidity and mortality for women (such as depression, osteoporosis, breast and lung cancer, most autoimmune diseases); or for which the causes, treatment and prevention (such as smoking, heart disease, dementia) need gender-specific responses. Importantly, there remains a tremendous need to support this work as governmental research funds decline and health care costs rise. To learn more visit www.yalewhr.org
10:40 AM on 11/17/2010
Thank you Ms. Streisand for supporting the heart disease in women's movement! I have been a blogger for Huffington Post since Huffington Post began and guess what I blog about... heart disease in women! It's fabulous to have a celebrity with your reach raising money for this cause. Gender specific research wasn't conducted until the 80's, so most of the procedures and treatments out there were standardized on men. This poses a major problem for the millions of women like me who went through an almost 2 year health crisis of misdiagnosis and treatments that failed or caused complications that lead to my emergency bypass at age 42. Dr. Noel Bairey-Merz and I are friends and have worked together for years. Her work on microvascular disease is world-renowned and will change how women in this country receive early detection, accurate diagnosis and proper treatment for their hearts. Your support will change the heart health outcomes of women nationally. And no matter what others say on this site, heart disease is the #1 killer of women in this country and more women than men have died of heart disease since the 1980's. Those are the facts. Women are not little men and the medical research, procedures and treatments done on women's hearts need to catch up to that fact to save the lives of our bubbies, moms, sisters, daughters and friends. Again, thank you for joining our fight!
09:23 AM on 11/17/2010
Thank you Barbara for this important information and for being the fantastic role model for women that you are!! Research also reveals that women often react very differently to medications than men do. Another reason why animal testing should be eliminated and is often irrelevant as animals and humans react differently to drugs. Women see doctors far more often then men and still do not receive equal respect. Mammograms may actually be contributing to breast cancer, use thermography exams instead, they are safe!
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Damiano Iocovozzi MSN NP
09:00 AM on 11/17/2010
Thank you for your nice article about women & heart disease, Ms. Streisand. Know that heart disease is the number one killer of both men & women in the US. For those who have passed all cures, or remissions or reprieves from advanced age, cardiac disease or dementia, there are effectively few voices advocating sane end of life care. The medical disease mongering and advertisements are filled with unrealistic expectations for those who have enetered a terminal decline due to a cardiac or respiratory illness. Because of the war mentality on decline, death & dying, those who have surpassed most medical intervention remain lonely, isolated & depressed while everyone around them is swirling in denial, including the medical providers. Please advocate, Ms. Streisand, on behalf of those in that pilgrim's space who must soon pass away. Please be that light and change agent who sees the whole life span, with a natural beginning & end. Pursuing a cure orientation for those beyond cures or remissions is very costly for the individual, & their families. The pursuit of wrong-headed cure orientations on those past benefit also causes intense physical suffering in places like the ICU or CCU where no honest medical goals can be achieved. It also costs billions of dollars in medical futility. Please be that voice, Ms. Streisand. Please visit my web page at http://www.soonerorlaterbook.com Damiano de Sano Iocovozzi MSN FNP CNS at the Thomas Edwin Walls Foundation, Palm Springs
02:47 AM on 11/17/2010
My Goodness! Ms. Streisand makes a well documented point and asks women in particular to be pro-active and what do I read?.... comments that seek to continue the "Men Vs. Women" dialogue. Read the article and look after your hearts, people!
02:34 AM on 11/17/2010
I can only agree with this article - when I was in my 30's I had a mild heart attack and was told by my doctor to "walk it off" like nice relaxing walks in the park. The heart attack was NEVER treated until in 2003 I was dignosed with congestive heart failuer that got so bad that in 2006 I had a pacemaker/defibrillator implanted and in May 2009 I received a heart transplant. My heart was examined and scars from the heart attack were found ... But, as my doctor said back then; Women that young don't have heart attacks and there is nothing to worry about and a little bit of rest will take care of everything.