So what's standing in our way? The biggest obstacle women mentioned in the AHA survey: family obligations and caring for others. Similarly, 28 percent said that they were too stressed to do what they needed to protect their hearts. "Ironically, some of the things that help your heart, like exercise, also reduce stress," says Christie Ballantyne, MD, head of cardiovascular disease prevention at Baylor College of Medicine in Houston.
The AHA and Heart Truth surveys also revealed that women tend to underestimate their personal risk of heart disease. "Many women have a false sense of security, which is only fostered by their doctors," says Malissa Wood, MD, codirector of the Massachusetts General Hospital Heart Center Corrigan Women's Heart Health Program in Boston. "Most routinely do mammograms and Pap smears, but they're less likely to talk to female patients about cholesterol, blood pressure and glucose levels."
Some women also think that they don't have to worry about heart disease until they're older—but what you do in your 20s and 30s impacts your risk later.
Of course, lifestyle changes don't happen overnight. But once you become aware of your obstacles, you can take steps to overcome them. Here, we profile four women who conquered their own barriers and triumphed over heart disease. Read on for their inspiring stories and learn how you can incorporate heart-healthy changes into your own life.
"I knew smoking was bad for me, but I had no idea how bad it was for my heart."
Susan Hayne, 50, Memphis, Tennessee
Looking back, I now realize that I had signs of heart failure months before I was actually diagnosed. I couldn't walk from one end of the house to another without being out of breath, which I assumed was just because I weighed 300 pounds and smoked a pack of cigarettes a day. Finally, in May of 2008, I realized something might be seriously wrong. For weeks I would come home from work so exhausted that I crawled straight into bed. By June, my husband insisted that I go to the doctor.
At my appointment, the doctor examined me, did X-rays—and told me that he was sending me to the hospital right then for a CT scan. He thought I had fluid in my lungs and had congestive heart failure, which means that your heart can't pump enough blood throughout your body, causing blood and fluid to get backed up. I was admitted to the hospital (which was attached to my doctor's office), still in shock. It took 10 days there to drain the fluid from my body: my lungs, my stomach, my feet. I left 60 pounds lighter.
During my stay, I was diagnosed with both congestive heart failure and type 2 diabetes. Sitting in my hospital bed watching all the machines around me pump water out of my body, I realized that I could either change my habits or die. There are many causes of congestive heart failure, but in my case, it was mainly due to lifestyle. I was overweight, smoked, and had high blood pressure and high cholesterol, all of which were extremely hard on my heart.
When I went to my doctor for a checkup a few weeks later, he told me that if I picked up another cigarette, I was signing my own death warrant. I was floored—I knew smoking was bad for my lungs, but I never realized it was so dangerous for my heart. I had already made the decision that I'd try not to smoke while in the hospital, so I'd gone through the initial withdrawal phase. But my doctor scared me into never touching a cigarette again.
To help curb the urge to light up, I ended up eating a lot, but I chose healthy options like light microwave popcorn or cut-up fruit and vegetables. The hospital had given me information about diet from the American Diabetes Association, and I immediately started reading food labels and counting the sodium, carbohydrates, calories and fat in everything I ate. I also started cooking more. Fifteen months after I left the hospital, I had lost over 150 pounds.
In order to help my heart recover and maintain my weight loss, I had to exercise. But this was the hardest thing for me to do. After working for 10 hours, then coming home to take care of my family (I have two children, now 18 and 25), it was easy to put it off. In the beginning, I was too obese to really do much of anything, but as the weight came off, I become more active. My mother-in-law introduced me to Zumba—a Latin dance-based workout—in 2009, and I was hooked: You're moving to great music, so it doesn't really feel like work. Now I do Zumba twice a week and walk on the treadmill at a gym near my daughter's school for a half-hour two or three times a week.
I'm very fortunate that once I set my mind to it, I lost weight and quit smoking. My brother, sadly, wasn't so lucky: Just two months after my diagnosis, he died of congestive heart failure. He wasn't overweight, but, like me, he had been a lifelong smoker. Although the damage to my own health will never completely be repaired, some of it has been reversed. I'm so grateful that my husband forced me to go to the doctor that day two years ago. Photo: Steve Jones
"Heart-healthy habits weren't in my culture."
Migdalia Rivera, 39, New York City
I had no idea that my son Karl and I were both at risk for heart disease until about a year ago, when we went for our annual checkups. When I learned that I had borderline high cholesterol I was surprised—but I was even more shocked to learn that my then 15-year-old son's cholesterol was higher than mine! Sure, I knew he was overweight, but I had no idea he was at risk for heart disease. The doctor said that if he didn't change his habits, he'd have to go on medication.
That really frightened me. I didn't want him to have to take those kinds of drugs when he was so young. I also didn't want to see my son go down the same path as my mother and our other relatives. Heart disease runs in my mother's side of the family—about 10 of her relatives have undergone open-heart surgeries, and a few years ago my mother herself had a stroke. I also realized that if I was going to take care of my children (I have a 9-year-old son, too), then I would have to take care of my own health as well.
There was no doubt in my mind that my culture (I'm from Puerto Rico) had a lot to do with our unhealthy eating habits, because our family celebrates events with food instead of activities. On weekends, instead of being active outdoors, the three of us would pile into my car and drive an hour and a half to visit relatives. Once we were there, we would eat fat-laden meals like pork skin fried in oil. Even if we weren't hungry, we were expected to eat. Many of my relatives also live in neighborhoods where they can't get fresh produce, whole-grain breads or lowfat milk and yogurt. As a result, we were easily getting a day's worth of calories in one afternoon meal.
We also never exercised, in part because we weren't encouraged to do sports in childhood (in fact, in my Latina culture, it was considered "not proper" for girls to do any kind of athletics). As a result, I never really exercised with my kids—not even walking.
After finding out that Karl and I had high cholesterol, I knew I had to make some changes fast, so I went to the AHA's website, where I found a site dedicated to Latina women (). The changes I made were pretty simple: I started serving yogurt and oatmeal for breakfast instead of bagels or pastries. For dinner, I began using whole-grain rice and breads instead of the white versions. I used egg whites instead of whole eggs, and served Jell-O instead of brownies for dessert. I started baking chicken and other meat instead of frying, and made sure we had fatty fish like salmon or tuna—which are high in omega-3s that may help lower cholesterol—once or twice a week.
We also now try to walk everywhere instead of relying on buses or subways, and I bought an inexpensive treadmill and elliptical machine so I can slip in a workout while my sons are at school. On weekends we still visit relatives, but I make sure to incorporate some exercise into the day, like stopping at a park before or after to play handball.
Karl initially resisted these changes. Every time I mentioned his weight and cholesterol, he walked away from me because he thought I was attacking him. Finally, after a couple of weeks, I told him that if he did develop heart disease, it would clog up his arteries, which would affect all his organs, including the ones he needed for sexual performance—which is what boys his age are starting to be concerned about. A lightbulb went off. Now, he walks a mile and a half home from school every day and regularly lifts weights.
Today, Karl has lost about 30 pounds and I have lost 20, and our cholesterol is back to normal. Just the other day, we were all in the grocery store. When I reached for a carton of ice cream, he stopped me and said, "Mom, don't buy that. Buy this brand instead. It's got less fat. Photo: courtesy of Bia Sampaio
"I didn't realize the importance of family history."
Molly Clayton, 34, Iota, Louisiana
I grew up thinking that dying from a heart attack was just a fact of life. It seemed like everyone in my small Southern town (and many family members) eventually died from complications related to diabetes or heart disease. So at age 23, I didn't think much of the fact that I was 5'3", weighed 238 pounds, and was so out of shape I couldn't make it up a flight of stairs.
Back then, I was working as a personal chef in Detroit. One day, I went to a doctor because I had flu-like symptoms and he insisted on doing a complete physical. He started asking about my family health history. I told him matter-of-factly that three of my four grandparents had heart disease combined with diabetes or cancer and that the fourth was suffering from congestive heart failure. He looked worried as he told me that I had the worst family history he'd heard in his 30 years of practicing medicine. He said I was a walking time bomb, and that if I didn't make some serious changes there was no way I would live very long.
I was completely thrown for a loop; I couldn't wrap my brain around what he had said. Until that point, dying of complications from heart disease just seemed like a normal part of getting older, but here was this doctor telling me that it wasn't. I didn't want to die young. I wanted to get married, have children, and live a long and happy life. The problem was that I had no idea how to turn my lifestyle around and the doctor didn't give me any suggestions (other than to watch how much fat I ate) or schedule a follow-up appointment. I literally went home and prayed for help. The only thing I knew how to do was to restrict calories, so I started cutting down portions.
Six weeks after my eye-opening appointment, a local dietitian called me because she was looking for a chef to create healthy meals for her clients. She said, "I know how to make it healthy, but I need you to make it tasty!" That was the start of my lifestyle overhaul. Thanks to her, I learned how to create heart-healthy meals that would help lower cholesterol and reduce diabetes risk. I learned how to sneak fiber and flaxseed into foods, and found healthy alternatives to butter (like applesauce) for baking.
Once I started losing some weight, I added exercise to my daily routine. At first, I could barely walk down the block, but within a few months I was walking for 30 minutes each day. As a result, I lost 40 pounds—and have kept it off for over 10 years. My blood work is now normal: At my last physical, my blood pressure was 118/75, and my total cholesterol was 150.
Today I work as a healthy chef (I got my clinical nutrition counselor certification at my community college) and offer supermarket tours, counseling, healthy cooking classes and a meal delivery service in my hometown. I want to help others who are uneducated like I was learn how to make better eating choices and understand that you can shop heart-healthy at stores like Walmart. I also got married and became a mom to three kids (7-year-old twins and a 5-year-old) a year ago and recently had a baby of my own. My older children know how to read food labels and watch out for things like hydrogenated oils and saturated fat.
I'm determined to break the cycle of heart disease in my family. I want my kids to have a healthy role model to talk about when they discuss their own family history with their doctor. Photo: courtesy of Sara Essex Bradley
"My doctor didn't listen."
Linda Couch, 47, Atlanta
When I was 26 and five months pregnant, I went into labor. My doctor sent me to the hospital and started me on medication to stop the contractions. Almost immediately I felt my heart racing, and I panicked: My mother, grandmother and four of my aunts all died of congestive heart failure, and my mom was only 35 when she died. I told my doctor, but she assured me it was just a side effect of the medication.
I was discharged about a month later, but soon started having trouble breathing and my ankles and abdomen became very puffy. I complained to my doctor, who dismissed these as normal pregnancy symptoms. On three occasions, I was sure I was in labor, so I went to the hospital only to be sent home.
Finally, when I was 30 weeks pregnant, I went to the ER because I couldn't breathe at all. Nurses took my blood and it was black, and a stethoscope exam revealed that my lungs were filled with fluid—sure signs of heart failure. A doctor delivered my son (he was just 5 pounds, but healthy). My condition wasn't preventable, but if it had been caught earlier we might have scheduled a c-section to avoid straining my heart.
I was released two weeks later with a slew of medications and told that I would one day need a heart transplant. At age 34, my condition worsened, and I was urged to move closer to a transplant center. I headed to Atlanta, where Emory medical center is and my sister Valerie lived. Just a month later, the unthinkable happened: Valerie was diagnosed with congestive heart failure, and she died 18 months later. Like our mother, she was only 35. Although I was getting sicker and already raising my son on my own, I ended up fighting for—and winning—custody of her two younger sons.
About six months later, my heart transplant finally came through. I often wondered where my new heart came from, and every year I sent a letter of gratitude to LifeLink, an organization that delivered my letter to the donor's family. It always went unanswered.
Then in 2009, nine years after my transplant, my friend was in a barbershop when he overheard the barber talking about how her boyfriend's 15-year-old daughter had died in a car crash and the family had been getting letters from the woman who received her heart—a single mother who was raising two adopted nephews. My friend immediately made the connection.
I met the family, and I gave the girl's sister a painting of an angel that I had been working on for years. To me, the angel represented my donor, so it seemed fitting that her sister should have it. Photo: courtesy of Christopher T. Martin