Rachel Graham suffers from the disease that claimed both her mother and her grandmother — mitral valve regurgitation. The condition, which can lead to stroke and heart failure, causes blood to leak backward into the heart.
Graham said her mother was misdiagnosed with pneumonia — and then dismissed by her doctor when her symptoms persisted.
“By the time they found out what was wrong, it was too late,” she said. “She went under for valve replacement surgery and never came home.”
History began repeating itself when Graham, experiencing symptoms, had an ultrasound on her heart, showing she had mild mitral valve regurgitation.
“Even though there was a family history,” she said, “my primary care physician wrote it off and said, ‘You just need to lose weight.’”
But the disease affects all body types, and Graham had gotten it despite being physically active. Luckily, she was able to find a “superhero Black lady doctor” who addressed her concerns.
Graham belongs to the executive leadership team of the American Heart Association of Greater Maryland’s Go Red for Women campaign. The initiative aims to increase women’s heart health awareness and decrease deaths by heart disease, which kills more women than all cancers combined.
And to stay ahead of her condition, she’s cautious about what she eats and how intensely she exercises. The most important thing?
“Having a doctor who will sit and listen and think through what the solution should be,” she said. “We know our bodies better a lot of the time than anyone else does. If you feel like something isn’t quite right, then you need to insist that your physician look deeper until you get the answers you want.”
Inequities in heart health
Graham and her mother’s experiences speak to heart health disparities for women and Black people. Another example? Women are more likely to experience atypical heart attack symptoms like dizziness and indigestion, which providers are often less aware of.
For women, high blood pressure during pregnancy is an important risk factor for heart disease — even years after a pregnancy.
And after menopause, women’s risk for heart disease “increases and may even exceed that of males,” said Dr. Ari Cedars, a Johns Hopkins cardiologist. Risk factors for heart disease like diabetes and smoking cause greater risks to women than men.
Additionally, the Mayo Clinic says that depression and stress — some from gender discrimination and balancing work and family — affect women’s hearts more than men’s.
Black people face elevated risk of heart disease largely because of structural racism and related stress, according to the AHA. For example, decades of racist policies have kept Black families segregated in neighborhoods with few fresh or healthy food options.
“Some of what we do is related to genetics and predisposition, but there’s also a huge element that has to do with things like where you live, what’s your zip code, what’s your socioeconomic status,” said Dr. William Ashley, a LifeBridge Health neurosurgeon and president of the Board of Directors for the AHA of Greater Maryland.
Cedars said patients and physicians should make sure to discuss whether certain medications are affordable and if not, find effective substitutes.
“We think we’ve done our due diligence simply by providing a prescription,” he said. “Physicians can do a better job — I know I could probably do a better job — of addressing the issues that confront patients in a culturally sensitive way.”
Dr. Seth Martin, a Johns Hopkins cardiologist and member of the Board of Directors for the AHA of Greater Maryland, rolled out a virtual cardiac rehabilitation program that is helping bridge heart health inequities for women and Black people.
“We’re putting the information and tools for people to be successful after a major cardiac event in the palms of their hands, in their smartphones — rather than them having to take off from work or struggle to get transportation to the hospital,” he said.
Tips for heart health
If doing minimal activity leaves you winded, you should get your heart checked out, said Dr. Jehan Riar, a primary care physician at Mercy Medical Center.
According to Cedars, chest pain and shortness of breath with exertion can be signs of coronary vascular disease, the most common type of heart disease in the U.S. Heart palpitations can suggest an arrhythmia, or a potentially life-threatening irregular heartbeat. Swelling legs and feet, he said, can indicate heart failure.
To avoid getting to that point, Cedars recommends avoiding salty foods like lunch meats and restaurant cuisine. High-salt diets are linked to hypertension, one of the top risk factors for heart disease. According to America’s Health Rankings, 34.3% of Marylanders have high blood pressure, higher than the national average (32.5%).