Dr. Evelyn Cusack Landesman

STAMFORD – Dr. Evelyn Cusack Landesman is a physician with The Heart Physicians in Stamford, a practice affiliated with Stamford Hospital.
She will be part of a “Women Living Healthy in 2011,” a women’s health and wellness fair presented by The Center Women of the Stamford JCC, in partnership with Stamford Hospital, on Feb. 10.
She spoke with the Ledger about maintaining women’s heart health.

Q: What are some misconceptions about women and heart health? How has awareness of, and attitudes toward, women’s cardiac health changed in recent years?

A: Until about a decade ago, heart disease was viewed as a man’s disease. Women with chest pain were thought to be anxious or nervous. Women also present with different symptoms than men many times: we have more shortness of breath, indigestion, decreased exercise ability, a feeling that something is just not right.  Men will more likely to come in with chest pressure and heaviness. This leads to a double-edged sword: in the past, physicians were not recognizing the signs and symptoms, nor were the female patients! In addition, women present later than men, due to the protective benefits of estrogen. So when a woman has a heart attack, she is usually older, with more concomitant illness, and has a lower survival rate. To further complicate matters, most of the information we had in the past about how to treat heart disease was studied in men only.  Thankfully, clinical trials studying women and heart disease began in earnest. We learned a lot in the treatment of women; we realized women are not just smaller men.

Q: Please talk about Go Red for Women and other efforts to bring awareness to the issue of women’s heart health. Why is there a need to bring special attention to the topic?

A: The “Go Red” movement was created by the American Heart Association (AHA) in 2004. At that time, nearly half a million women were dying from heart disease. The goal of the “Go Red” movement is not only to educate but to fund research. As I said, most of the trials before this included men only and we are realizing that there are some very important differences. Since its inception, the death rate from heart disease has continued to decline. Women are getting diagnosed earlier, thus saving lives. Heart disease is more prevalent in women than even breast cancer! Only about 55 percent of women are aware of this statistic. So the mandate was simple: increase education, not only to physicians, but to patients. Fund more research as to how and why women are different.
The AHA uses the money it raises to support awareness, research, education, and community programs to benefit women. There are amazing events coming up, especially in February, which is “Go Red’s” month. Local hospitals, including Stamford Hospital, host heart health events for women regularly.
Personally, I give lectures, participate in health round-tables, and give interviews all throughout the year to get this message out, as do countless other physicians. We do this because it really does make a difference. Changing attitudes and behavior is the single most important step in fighting heart disease. Eighty percent of heart disease is preventable. If I am able to give some steps in moving toward a more healthy lifestyle, I have significantly reduced your risk. The recommendations I give also confer benefit for reduction of cancer risk as well. Good health is good health. The research that the AHA funds is vital too. We have learned so much on how women are subtly different then men, which has changed the way we diagnose and treat women.

Q: Heart Health 101: What are a few steps women can take to initiate, monitor, and maintain their cardiac health?

A: Knowledge is key! Know your risk factors. Know the symptoms in women. See your doctor regularly to get screened for the risk factors; you don’t know if you have high blood pressure or cholesterol unless it’s checked. Once your risk factors are identified, you must address them. If you have high blood pressure or high cholesterol, you must treat it if you can’t get it down by lifestyle modifications. If you have had a heart attack or known coronary disease, medication can be life-saving. I believe that for primary prevention – people without known disease – it is usually best to start with lifestyle changes. With close monitoring, if that doesn’t work, go to medication.
Make the changes, any change. Start moving, any exercise at all. Even if you can only manage five minutes a day, build up. Pick something you like to do. I tell people to take laps in the mall. Start slow and increase as you can. Always check with your doctor first.

For more information on “Women Living Healthy 2011” health and wellness fair on Thursday, Feb. 10 at the Stamford JCC: www.stamfordjcc.org / (203) 322-7900