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As Barbra Streisand astutely notes, “It’s not an old man’s disease”

Lady killer

Stop marginalizing heart disease

By Kara Cutruzzula on April 23, 2015

“Women still think: ‘You better not talk about heart disease because it’s an old man’s disease,’” said Barbra Streisand during a discussion that shattered some of the myths surrounding heart disease and exposed the issue of gender bias in medicine. “I think women are still viewed as second-class citizens. It’s still a kind of old boys club, and whether it’s politics or in the workplace, it’s also there in medical research. For the last 50 years, most of the research has been done on men,” said the singer, actor, director and philanthropist during the second afternoon of the Women in the World Summit.

Streisand was joined by Dr. Holly Andersen, Attending Cardiologist and Director of Education and Outreach, Ronald O. Perelman Heart Institute New York-Presbyterian Hospital/Weill Cornell Medical College, and Vanessa Noel, a CEO, hotelier, and women’s shoe designer, in a panel moderated by ABC News Senior Medical Contributor Dr. Jennifer Ashton.

The statistics on women and heart disease are dire. “Unbelievable,” said Streisand. In the last few years, 40,000 women have died of breast cancer a year, while 400,000 women died of heart disease. Globally, around 500,000 women succumb to breast cancer, and 8.6 million die of heart disease.

“I can’t stand any kind of gender discrimination,” said Streisand to explain why she decided to focus on heart disease by co-founding the Women’s Heart Alliance and donate $22 million to what is now the Barbra Streisand Women’s Heart Center at Cedars-Sinai medical center in Los Angeles. And there’s plenty of bias when it comes to heart disease. “The Yentl Syndrome” was coined in 1991 by Bernadine Healy, the first female director of the National Institutes of Health, because just as the titular protagonist of Streisand’s critically acclaimed film Yentl had to disguise herself as a man to become a scholar, women who don’t present with heart disease symptoms that look like a man’s symptoms were “misdiagnosed, mistreated, and ignored,” said Streisand. “Take Pepcid. That’s what that was.”

It took four months for Vanessa Noel to convince her doctors that she had heart disease. Her first symptoms? Tightening in her chest and a localized pain, but even she initially dismissed it as “maybe I’m dehydrated.” (Meanwhile, 40 percent of women having heart attacks have no chest pain, and may only have some pressure or indigestion, or an overwhelming sense of fatigue or lightheadedness.)

Noel saw three doctors and had a diagnostic workup, but didn’t have any cholesterol issues or high blood pressure. “They ask you the stupidest questions about being a female: ‘Are you on your period? Are you having a fight with your boyfriend?’ They did a sonogram, an EKG, and said my esophagus was spasming, and I told them, “It’s not. It’s my heart.”

In fact, it wasn’t until Noel actually had a heart attack in her doctor’s office that they realized how many symptoms they had missed. “It was inconceivable even to me that I had a heart attack,” said Noel, who at that point had a 99 percent near total occlusion in a major artery. (But in an extraordinary feat of multitasking, she even snuck her phone into the cath lab, called the businessman she had a meeting scheduled with and told him she’d have to see him later because, well, she’d just had a heart attack.) Noel wants her near-disastrous experience to serve as a warning bell to others: “And it sounds cliche to say that if I can do it, any of you can do it.” She added, “Save yourself before you have the heart attack. Go get checked. Listen to your body. Talk to the doctors, and Google everything and educate yourself as well. And then find a really good doctor.”

“I think there’s a kind of stigma attached to having heart disease,” said Barbra Streisand. “A lot of women don’t even know they have heart disease. I was talking to a friend and she said she didn’t have heart disease, and I asked her: ‘Didn’t you have an ablation? I think that’s heart disease.’”

Dispelling the stereotype that heart disease is limited to men, and older men at that, Andersen noted that death rates due to heart disease have increased in women aged 29 to 40 and that there needs to be increased awareness in young women. Yes, we’re talking millennials. “We put all our money into treatment and we put very little money into prevention,” she said. “This is why we want to empower women to be their own advocates and patients.”

Breast cancer awareness has been one success story, but as Streisand noted, that campaign started 30 years ago, and heart disease has a long way to go. As for what women can do, the panel had plenty of advice: They must tell their doctors about their family histories, and ask to get their hearts checked. “I think women should write congressman and congresswoman to ask for more funding,” Streisand said, highlighting the disproportionate amounts of money given to various diseases. (Women’s heart disease research gets less than a quarter of the amount of money the NIH gives to women’s breast cancer research.)

Streisand closed out the discussion with a rousing call to action: “You have to fight for being valued. If you believe in the power of yourself, and in every voice, every vote, and being your own advocate, and feel that you deserve the best in health care and in what your government can give you, then you will take better care of yourself.” In other words, when it comes to this life-threatening issue, perhaps it’s time for a change of heart.