Make no mistake: Heart disease isn’t just a “silent killer.” It’s the leading cause of death for women in the United States. Despite this fact, research and detection for women’s heart disease have traditionally fallen short, failing to address how stages of a woman’s life directly impact heart health.
Enter Nishtha Sareen, an interventional cardiologist at Ascension Saint Thomas and the guiding force behind the hospital’s Heart Women’s Program — the only resource of its kind in Middle Tennessee. “It’s very close to my heart when I say [care] should not be a luxury — it should be a necessity,” says Nishtha. “I think we have faltered in the ability to bring heart health to the doorsteps of women in our community.”
Nishtha and her team recognize that heart disease isn’t exclusive to the heart. Rather, the entire body contributes to the organ’s overall health. To provide well-rounded aid, the women’s heart program offers an all-inclusive approach to testing, health care and lifestyle guidance. This is made possible by 13 “champions” in various fields, including radiologists, breast surgeons, pregnancy-related heart disease specialists, electrophysiologists, mental health experts, and dietitians.
Addressing the Risks
Nishtha’s passion for her field pours out of her when she speaks — so do facts about heart disease. “Heart disease in women is six times more common than breast cancer,” she says. “It’s more common than all cancers combined.”
To provide effective care, Nishtha recognizes the importance of educating patients about symptoms, underlying risk factors and how heart disease presents differently in women and men. For instance, rather than having a “Hollywood heart attack,” many women experience symptoms like lightheadedness, nausea and shortness of breath.
Nishtha asserts that these differences are largely understudied and underdetected, as are women’s increased risks for the condition. “A woman who is post-menopausal and develops diabetes is at six times higher risk of a stroke and heart attack, compared to a man who has diabetes,” says Nishtha. “He’s only two times higher risk.”
This discrepancy is blatant, even in clinical trials. Between 85 and 90 percent of participants who’ve been studied for heart disease are male. Despite disproportionate medical data, women are still prescribed the same heart disease medications as men, which haven’t been properly tested for their genetic makeup and may pose a higher risk of certain side effects.
Diabetes, hypertension and high cholesterol are common risk factors associated with heart conditions. And women with atrial fibrillation need to automatically be put on blood thinners due to higher risk of stroke. Before the women’s heart program, many medical environments overlooked the ways women’s heart health relates to pregnancy, menopause or age. “If you look at the women’s heart centers that exist in the United States overall, they have failed to address every stage of a woman’s life,” says Nishtha.
Forging Solutions
To address these disparities, the women’s heart program holistically examines each patient’s lifestyle. In addition to offering effective detection and treatment, the program has on-site dietitians who provide custom guidance about what patients should eat, depending on their symptoms. The program has also partnered with the Ascension Saint Thomas West and Rutherford Wellness Centers, offering discounted exercise memberships for only $18 a month.
To amp up its impact, the women’s heart program recently kicked off its “250 screens in 250 days” initiative, where medical professionals offer public heart health screenings to teachers; women impacted by domestic abuse, prostitution and drug violence; and the ancillary staff at Ascension Saint Thomas. At public screening events, each patient receives a blood pressure check, a body mass index measurement, a heart rhythm test and a one-on-one session with a specialist. (When Nfocus spoke with Nishtha in September, the Ascension Saint Thomas staff was 25 days into the program and had already provided scans for approximately 200 people.) “If any woman is healthy, the next generation is healthy,” says Nishtha.
Women’s heart program leaders also want to help women learn about their heart disease risk when they get routine mammograms. “The issue lies in lack of advocacy,” says Nishtha. “We have the technology, we have the ability to learn about women, but we have to first recognize that there is a need and step forward to address it.”
Rallying Community Members
As she tries to make heart health care more accessible, Nishtha has seen patients encounter two main challenges: getting in touch with someone and living far from a care provider. To combat these challenges, the program opened three centers — in Midtown, Murfreesboro, and Franklin — within the span of a year. “We try to recognize areas that are underserved, where we don’t have specialists, and we go in those areas with wide services,” says Nishtha.
While there are more resources available to women in Middle Tennessee than before, true power comes in numbers — and through support from patients’ local and personal communities. Nishtha hopes that, by increasing awareness, she will not only inspire women to take charge of their health but also urge the men in their lives to advocate for better care.
“The only reason we have made so much stride in the heart health of men is because of the women in their lives — their mothers, their wives, their daughters,” says Nishtha. “This responsibility is on the shoulders of the men in our society. They have to push forward for the heart health of women.”
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