An early focus on prevention and controllable risk factors are keys to addressing and improving women’s cardiovascular health, says A.T. Still University-Kirksville College of Osteopathic Medicine (ATSU-KCOM) alumna Suzanne R. Steinbaum, DO, ’94, FACC, FAHA.
Dr. Steinbaum presented the 2020 Fred C. Tinning, PhD, DOEd (hon.), ’14, Founder’s Day Osteopathy Virtual Lecture on Thursday as part of ATSU’s Founder’s Day celebration. The late Dr. Tinning, ATSU president emeritus, and his wife, Janet, established an endowment in 2009 to provide for an annual lecture on osteopathic medicine.
Author of “Dr. Suzanne Steinbaum’s Heart Book: Every Woman’s Guide to a Heart-Healthy Life,” Dr. Steinbaum is an accomplished attending cardiologist specializing in prevention. She has served as director of women’s cardiovascular prevention, health, and wellness at Mount Sinai Heart and director of women’s heart health at Northwell Lenox Hill, both in New York. She’s been named to the New York Times’ “Super Doctor” and New York Magazine’s Best Doctors lists, and is a fellow with the American College of Cardiology and American Heart Association. She was recently named to the Women’s Heart Alliance scientific advisory board and appears regularly as a guest on network television shows to discuss women’s cardiovascular health.
Dr. Steinbaum said study and attention to women’s heart health was far from prevalent in healthcare for many years, referencing heart disease prevention campaigns that focused on men from the 1960s through the 1990s. Women’s only role seemed to be awareness, not for themselves, but for taking care of their husbands.
She recalled a case from her residency with a 53-year-old woman presenting with chest and stomach pains. The patient was evaluated by emergency room doctors and diagnosed with gastroenteritis. Not long after, she died from sudden cardiac arrest.
It was Dr. Steinbaum’s “ah-ha” moment.
“It was like everything stopped,” she said, “and I thought to myself, ‘Here’s this young woman who had a heart attack in front of us. Does anyone else see what’s going on here?’”
When Dr. Steinbaum graduated from ATSU-KCOM, only 13% of cardiologists were women. As she set out for fellowships in women’s heart disease and prevention, she found they didn’t exist. She also described an overall gender bias in women’s health treatment, with a focus on reproductive systems and disregard for overall health.
“This was truly an allopathic approach to disease,” Dr. Steinbaum said. “Women were not looked at holistically. They were looked at for their organ systems, their body parts.”
Things changed as more women took leadership roles in healthcare fields and public health organizations, and awareness of women’s cardiovascular health issues entered the mainstream. Studies show more women die of heart disease than all cancers combined, and in 64% of women’s heart disease cases the first symptom was sudden cardiac death.
Dr. Steinbaum said prevention is key, identifying nine modifiable risk factors that cause 90% of initial heart attacks. She said doctors should focus on improving patient health in areas of cholesterol, blood pressure, diabetes, smoking cessation, abdominal obesity, sedentary lifestyle, fruit and vegetable consumption, alcohol consumption, and psychosocial risk factors.
The earlier they are addressed, the better for long-term outcomes.
“It is empowering to think that we can help people’s lives be changed by changing these risk factors,” she said.
“We’re developing a holistic view of how women’s lives affect their hearts.”
Watch Dr. Steinbaum’s lecture at bit.ly/2020TinningLecture.