Cardiovascular Health

A Mediaplanet Guide to Lowering Risk of Cardiovascular Disease

Cardiovascular Health

Barbra Streisand The award-winning director, actor, and singer is helping women recognize the signs of CVD

It’s time to rethink cardiovascular risk. Learn how Amarin can help Discover the dangers of older adults postponing cardiovascular care MARCH 2021 | FUTUREOFPERSONALHEALTH.COM

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Maternal Health Helps Shape Lifelong Heart Health

What Makes Cardiovascular Health a Global Priority OMRON’s Dr. Jim Li, executive director of Global Medical Affairs, explains the rationale for the company’s bold corporate mission “Going for Zero” — the elimination of heart attack and stroke.

As a scientist with a doctoral degree, I am passionate about empowering people to take charge of their health at home through technology and innovation. However, we are facing greater cardiovascular health challenges today than ever before.

Globally, more than 1 billion people are hypertensive, which includes 116 million adults in the United States alone. And of those American adults who are in the hypertensive range, more than 37 million have uncontrolled Stage 2 hypertension, which means they are at greater risk of heart attack and stroke.

These are frightening times, yet according to the CDC, 80 percent of heart attacks and strokes are preventable, and that requires active management of one’s condition.

Today, technology is enabling high standards for performance and accuracy in blood pressure measurement devices, making a measurable and meaningful impact on consumers who need to manage their hypertension. Technology has helped them gain important insights, enabling them to have a more complete picture of their heart health.

As the industry evolves, transforming the global heart health marketplace is a challenge that must be accepted. Medical devices to measure blood pressure have also advanced. There are more wearables with higher standards of accuracy and there are more health devices that take lifestyle into consideration.

One in 2 adults in the United States has high blood pressure. Make sure you know if you are one of them. Do yourself (and your loved ones) a favor — get a blood pressure monitor and take your measurements regularly.

Dr. Jim Li, Executive Director, Global Medical Affairs, OMRON Healthcare, Inc.

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Michelle A. Albert, M.D., M.P.H., Professor of Medicine (Cardiology), Associate Dean of Admissions, University of California, San Francisco School of Medicine

Women lead incredibly hectic lives, usually sacrificing taking care of their own well-being in order to nurture their families, friends, and colleagues.

However, they may pay an awful health price for doing so.

Heart attacks and strokes don’t only happen to men. Heart disease kills 1 in 3 people and is the No. 1 cause of death in women.

Reality debunks the myth that heart disease is an “old person” problem. Another truth is that women of color, particularly Black women, disproportionately succumb to poor outcomes related to cardiovascu-

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lar disease. In fact, an American Heart Association survey shows that younger women are less aware of their risk of heart disease than they were 25 years ago.

Alarmingly, Black women are at higher risk of dying from heart disease in comparison to some men. Let’s take a look at Michelle Emebo’s experience. She is a 36-year-old Black woman diagnosed with high blood pressure during the third trimester of her pregnancy. High blood pressure is the No. 1 risk factor worldwide for heart ailments. High blood pressure in pregnancy is a risk factor for serious health complications for both mom and baby, and such complications predict overall lower life expectancy.

Fortunately, Emebo delivered a healthy girl, but her blood pressure remained high for months and she struggled to lose weight. Even on medication, the problem persisted.

Healthy steps Emebo is thriving by

doing what she can — instead of eating out, she cooks a majority of her meals, and she avoids sugary and high-salt foods, and exercises several times a week. Both her weight and blood pressure are back to normal. She has been able to discontinue her blood pressure medication.

Emebo’s story mirrors so many of the ones we regularly see. The reality is that nearly 80 percent of cardiovascular problems are preventable through education and lifestyle changes like exercise, a healthier diet, and stress management.

“I really wanted it to be about my health, and not just physical health, but mental health,” said Emebo, whose parents both had strokes. “This was about breaking a family legacy of heart disease and stroke, and feeling good.”

Women of all ages, including younger women, must pay attention to and take steps early in life to ensure better cardiovascular health outcomes throughout life. Menopause heralds

a time when estrogen production drops in women. The loss of estrogen’s heart-protective effect hastens the pace toward poor heart outcomes in women after menopause.

Depression, anxiety, and sleep disturbances are common in menopause and are associated with increased heart disease risk, according to an American Heart Association scientific statement published in November.

Women of every age need to get quality sleep, manage stress, exercise, and seek professional assistance for health issues, particularly mental health concerns.

To decrease heart disease deaths among all women, access to high-quality, affordable, unbiased healthcare and assistance, with the prioritization of exercise, proper nutrition, healthy sleep habits, and stress management is necessary. The health of women is a window into the health of society; not only for their lives, but those in our society who depend on them. n

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Publisher Chloe Addleson Business Developer Joelle Hernandez Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Keziah Makoundou Lead Editor Mina Fanous Copy Editor Dustin Brennan Partnership and Distribution Manager Jordan Hernandez Director of Sales Stephanie King Director of Product Faye Godfrey Cover Photo Russell James All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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Bridging the Heart Care Gap Between Men and Women Here’s how we can ensure women receive the same quality of care and treatment for their hearts as men do: Heart disease is the leading killer of women in America, but only half of women are aware of that.

According to a 2020 study released by the American Heart Association, awareness about women’s heart disease has been on a steep decline.

The Women’s Heart Alliance — led by Barbra Streisand, Dr. Noel Bairey Merz, Dr. Holly Andersen, and a national board of leading cardiologists — has been working hard to raise public knowledge of the unique heart attack symptoms experienced by women, and is dedicated to reducing heart-related illness and death among women.

Our advocacy has helped get the federal government to increase research funding for the study of how heart disease impacts women, require researchers to show findings by gender, include female mice in cardiovascular research, and involve more women in clinical trials.

In part because of these changes, we’ve seen the number of women dying from heart-related

illnesses reduced from 1 in 3 to 1 in 4. While this is important progress, it’s not enough.

An urgent concern The COVID-19 pandemic has emphasized the urgency of improving heart healthcare for women.

The virus takes a tremendous toll on cardiovascular health, causing heart damage in many patients who didn’t have pre-existing heart conditions. There is growing evidence that those who have had COVID-19 can sustain serious heart damage months after being infected. Patients that experienced serious cases requiring hospitalization should consider having their heart checked.

The fight for gender equity is far from over. With the help of the public, federal and local government, and medical communities, there are several things we can do to ensure women receive the same quality of care and treatment for their hearts as men do.

Steps to take We must start by raising awareness of the specific symptoms of heart disease in women. This will ensure they receive proper care and

treatment in a timely manner, and ultimately save lives.

Next, we must educate the medical community on women’s heart health. Studies have shown that female patients are more likely to survive a heart attack when they are treated by a female doctor rather than a male doctor. This finding suggests gender bias or an education gap might be preventing male doctors from providing women with the care and treatment they need.

Finally, we have to fund cardiovascular research that includes women. Just as important as educating the public and doctors is increasing funding for research specific to women’s cardiovascular disease. Many of the disparities in how men and women are diagnosed and treated for heart disease stems from their unequal representation in research studies and clinical trials.

We’ve come far in our efforts toward gender equity in cardiovascular care and research, but we’ve still got a long way to go. As long as heart disease remains the leading killer of women, we’ll keep fighting. n

5 Ways to Turn Heart Failure Into Heart Success Living with heart failure is a lifelong journey, but a few simple lifestyle habits can go a long way in helping to manage this condition.

1. Know your symptoms Every heart failure patient has different symptoms that signal a worsening of the condition. This may mean swelling in the legs or abdomen, shortness of breath, chest pressure, or loss of appetite.

As soon as you notice a flare-up, seek medical attention.

2. Speak up Your input in your care is important. By telling your care team how you are doing, you help paint a full picture of how heart failure is affecting your quality of life. Keep a journal to make notes of how you are feeling each day (what does a good day vs. a bad day look like?), any aggravating triggers, and any bumps in the road.

3. Don’t miss doses Heart failure patients who take their medicine without missing doses have the best chance of keeping symptoms controlled. Use a pillbox or set an alarm on your phone to remember midday and evening doses, and always be sure to keep refills on hand.

4. Limit salt and fluids While clinicians prescribe diuretics (water pills) to control fluid buildup in the body, it is important to be mindful of the amount of salt and water being consumed.

Salt can cause the body to hold on to water, leading to swelling. Talk with your healthcare team about a heart-healthy eating plan that could work for you.

5. Log your weight Sudden weight gain can be a red flag that fluid is building up in the body. Weigh yourself each morning before breakfast — the danger zone is gaining 3 pounds in a 24-hour period or more than 5 pounds in a week.

Martha Gulati, M.D., FACC, Editor-inChief, CardioSmart

Women’s Heart Alliance MEDIAPLANET

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Small Steps to Improve Your Cardiovascular Health

The pandemic has changed our world in just a year. What has not changed is that small things matter. While small but important things can be easily overlooked amid a “big thing” like a pandemic, small changes can make a big difference when it comes to health.

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n the United States, heart disease is the leading cause of death and cerebrovascular disease is the fifth leading cause of death. More than 650,000 people die from heart disease and 150,000 people die from stroke each year.

While progress in ending the acute phase of the pandemic continues, the likelihood of dying from cardiac and vascular diseases has plateaued after decades of

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improvement. This troubling stall is most apparent among individuals ages 35-64, a season of life when many are serving as parents, caregivers, coworkers, family breadwinners, and neighbors. While each life is truly precious, these losses, many of which are preventable, leave holes in our homes, lives, and communities.

Stalled progress The reasons for the prolonged stall in cardiovascular health

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are myriad. Not every one of us has easy access to safe places to be active. Many Americans live in “food deserts” with limited access to affordable, healthy food.

Millions of people in the United States have conditions like diabetes and obesity that make heart disease and stroke more likely, and although rates have dropped a lot in the past few decades, over 34 million U.S. adults still smoke cigarettes. Perhaps most com-

pelling, half of adults have hypertension (high blood pressure) and only 1 in 4 of those has readings that are in the optimal range of less than 130/80 mm Hg. We know preventing heart disease, stroke, kidney disease, cognitive decline (a common form of dementia), and even major causes of harm during and following pregnancy is absolutely possible. Take one small step today to protect and improve your heart and brain

health. Keep practicing that small step until it’s a habit.

When you can, add a new step, but keep it small — make it permanent.

Find resources for choosing small steps with giant returns for your cardiovascular health at cdc.gov/heartdisease/prevention. n Janet Wright, M.D., Acting Director, Division for Heart Disease & Stroke Prevention, Centers for Disease Control and Prevention (CDC)

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Yet, nearly 80 percent of cardiovascular (CV) events — such as heart attacks and strokes — can be prevented.2 It’s time to #RethinkCVRisk to change the course of the disease and your life.

Risk factors for CVD include high cholesterol, high triglycerides, diabetes, and high blood pressure.3 Other factors, such as family history, smoking, being overweight, and unhealthy diet and exercise habits can also contribute.3 Over time, these risk factors can impact and injure the blood vessel lining, causing inflammation, which can then trigger plaque growth.4 As plaque builds up and potentially ruptures, the chances of having a heart attack or stroke increase if there is a blockage that forms. Blocked blood flow to the heart can cause a heart attack while blocked blood flow to the brain can cause a stroke.5 The difference between life and death can be traced to when you detect heart disease and how you reduce your risk factors. The first step is getting tested to understand your cholesterol and triglyceride levels

It’s Time to Rethink Cardiovascular Risk

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In America, one person dies every 36 seconds from cardiovascular disease (CVD). For the last two decades, heart disease has been the world’s biggest cause of death accounting for more deaths than cancer, diabetes, lung infections, and the flu.1

— two indicators for increased CV risk. Statins are currently the first-line therapy for lowering cholesterol; but statins, diet, and exercise can only lower your CV risk by about 25-35 per-

cent, leaving residual or “persistent CV risk.”6 At the same time, lowering triglyceride levels doesn’t necessarily reduce risk, but addressing the underlying cause does.7

In the past, fenofibrates and niacin were commonly prescribed to lower triglyceride levels to help manage CV risk.

However, clinical studies failed to show benefits and the U.S.

Food and Drug Administration (FDA) and American Diabetes Association (ADA) discourage combining niacin and fenofibrates with statins.8 Some turn to dietary supplement fish oil to help manage CV risk. However, supplements contain only 30 percent of the omega-3 fatty acids EPA and DHA (docosahexaenoic acid), with the majority of the product consisting of nonomega-3 ingredients, including saturated fats. Additionally, fish oil supplements are not FDA-approved medicines intended to treat or prevent a medical condition. Despite multiple clinical studies, these products have not been proven to reduce CV risk on top of current medical therapies including statins. Some data suggests certain ingredients in dietary supplement fish oils, such as docosahexaenoic acid (DHA) and saturated fats, may raise bad cholesterol. 9,10 With ongoing research, new standards-of-care are emerging.

High cholesterol is a key CV risk factor with statins currently the first-line therapy for lowering cholesterol. Talk with your doctor about FDA-approved options that can help further reduce your heart risk if you already take statins.

It’s time to #RethinkCVRisk to change the course of the disease and your life. n Craig Granowitz, M.D., Ph.D., SVP, Chief Medical Officer, Amarin Pharma, Inc.

Source: Amarin Corporation plc : 1. Heart Disease Facts. The Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/facts.htm#:~:text=One%20person%20dies%20every%2036,1%20in%20 every%204%20deaths; 2. CDC Prevention Programs. American Heart Association. https://www.heart.org/en/get-involved/advocate/federalpriorities/cdc--prevention-programs; 3. Know Your Risk for Heart Disease. The Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/risk_factors.htm. ; 4. Inflammation and Heart Disease. The American Heart Association. https://www.heart.org/en/health-topics/consumerhealthcare/what-is-cardiovascular-disease/inflammation-and-heart-disease; 5.Heart Disease: Coronary Artery Disease. The Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/coronary_ad.htm.; 6. Ganda OP, Bhatt DL, Mason RP, Miller M, Boden WE. Unmet need for adjunctive dyslipidemia therapy in hypertriglyceridemia management. J Am Coll Cardiol. 2018; 7. Scientific Statement. The American Heart Association. https://www.acc.org/latest-in-cardiology/journal-scans/2011/04/23/22/25/triglycerides-and-cardiovascular-disease-a-scientific-statement.; 8. Department of Health and Human Services. [Docket no. FDA–2016–N–1127]: AbbVie Inc., et al; Withdrawal of approval of indications related to the coadministration with statins in applications for niacin extended-release tablets and fenofibric acid delayed-release capsules. Federal Register. April 18, 2016;81(74):22612-22613.; 9. Hilleman D, Smer A. Prescription omega-3 fatty acid products and dietary supplements are not interchangeable. Manag Care. 2016;25(1):46-52.; 10. Davidson MH. Omega-3 fatty acids: new insights into the pharmacology and biology of docosahexaenoic acid, docosapentaenoic acid, and eicosapentaenoic acid. Curr Opin Lipidol. 2013;24(6):467-474.

For more information about CVD and what you can do, look for #RethinkCVRisk on social media or visit http:// bit.ly/AboutCVHealth.

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PATIENT INFORMATION VASCEPA® (pronounced vas-EE-puh) (icosapent ethyl) capsules What is VASCEPA? VASCEPA is a prescription medicine used along with certain medicines (statins) to reduce the risk of heart attack, stroke, and certain types of heart issues requiring hospitalization in adults with heart (cardiovascular) disease, or diabetes and 2 or more additional risk factors for heart disease. It’s also used along with a low-fat and low-cholesterol diet to lower high levels of triglycerides (fats) in adults.

It is not known if VASCEPA changes your risk of having inflammation of your pancreas (pancreatitis).

It is not known if VASCEPA is safe and effective in children.

Do not take VASCEPA if you are allergic to icosapent ethyl or any of the ingredients in VASCEPA. See the end of this summary for a complete list of ingredients in VASCEPA. Before taking VASCEPA, tell your doctor about all of your medical conditions, including if you: • have diabetes.

• have a low thyroid problem (hypothyroidism).

• have a liver problem.

• have a pancreas problem.

• are allergic to fish or shellfish. It is not known if people who are allergic to fish or shellfish are also allergic to VASCEPA. • are pregnant, or planning to become pregnant. It is not known if VASCEPA will harm your unborn baby.

• are breastfeeding or plan to breastfeed. VASCEPA can pass into your breast milk, and may harm your baby. Talk to your doctor about the best way to feed your baby if you take VASCEPA. Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and dietary or herbal supplements.

VASCEPA can interact with certain other medicines that you are taking.

Especially tell your doctor if you take medicines that affect your blood clotting (anticoagulants or blood thinners).

How should I take VASCEPA? • Take VASCEPA exactly as your doctor tells you to take it.

• Do not change your dose or stop taking VASCEPA without talking to your doctor.

• Do not take more capsules than what is prescribed by your doctor.

- If you are prescribed the 0.5 gram capsules, you should not take more than 8 capsules each day with food.

- If you are prescribed the 1 gram capsules, you should not take more than 4 capsules each day with food.

• Take VASCEPA capsules whole. Do not break, crush, dissolve, or chew VASCEPA capsules before swallowing.

• If you miss a dose of VASCEPA, take it as soon as you remember. However, if you miss one day of VASCEPA, do not double your dose when you take it.

• Your doctor may start you on a diet that is low in saturated fat, cholesterol, carbohydrates, and low in added sugars before giving you VASCEPA. Stay on this diet while taking VASCEPA. • Your doctor may do blood tests to check your triglyceride and other lipid levels while you take VASCEPA.

What are the possible side effects of VASCEPA? VASCEPA may cause serious side effects, including: • Heart rhythm problems (atrial fibrillation and atrial flutter). Heart rhythm problems which can be serious and cause hospitalization have happened in people who take VASCEPA, especially in people who have heart (cardiovascular) disease or diabetes with a risk factor for heart (cardiovascular) disease, or who have had heart rhythm problems in the past.

Tell your doctor if you get any symptoms of heart rhythm problems such as feeling as if your heart is beating fast and irregular, lightheadedness, dizziness, shortness of breath, chest discomfort, or you faint.

• Possible allergic reactions if you are allergic to fish or shellfish. Stop taking VASCEPA and tell your doctor right away or get emergency medical help if you have any signs or symptoms of an allergic reaction.

• Bleeding. Serious bleeding can happen in people who take VASCEPA. Your risk of bleeding may increase if you are also taking a blood thinner medicine.

If you have liver problems and are taking VASCEPA, your doctor should do blood tests during treatment.

The most common side effects of VASCEPA include: muscle and joint pain; swelling of the hands, legs, or feet; constipation; gout; and heart rhythm problems (atrial fibrillation).

These are not all the possible side effects of VASCEPA. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

How should I store VASCEPA? • Store VASCEPA at room temperature between 68° to 77° F (20° to 25° C).

• Safely throw away medicine that is out of date or no longer needed.

Keep VASCEPA and all medicine out of the reach of children.

General information about the safe and effective use of VASCEPA. Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use VASCEPA for a condition for which it was not prescribed. Do not give VASCEPA to other people, even if they have the same symptoms that you have. It may harm them. You can ask your pharmacist or healthcare provider for information about VASCEPA that is written for health professionals.

What are the ingredients in VASCEPA? Active ingredient: icosapent ethyl Inactive ingredients: tocopherol, gelatin, glycerin, maltitol, sorbitol, and purified water VASCEPA is a registered trademark of the Amarin group of companies. ©2019 Amarin Pharma, Inc. Bridgewater NJ, 08807. All rights reserved.

PP00120M Revised: 12/2019 Distributed by: Amarin Pharma, Inc. Bridgewater, NJ, USA Manufactured for: Amarin Pharmaceuticals Ireland Limited Dublin, Ireland +1-855-VASCEPA (+1-855-827-2372) www.vascepa.com For more information, go to www.vascepa.com or call 1-855-VASCEPA (1-855-827-2372).

This Patient Information has been approved by the U.S. Food and Drug Administration.

Why Older Adults Can’t Ignore Cardiovascular Care During the Pandemic

Cardiovascular disease remains the No. 1 cause of mortality in the United States. During the COVID-19 pandemic, older adults were advised to stay at home to minimize risk of infection, however, delays in seeking cardiac care can have unintended consequences.

Denying symptoms and delaying care due to fear of COVID19 infection was a common finding in the early phase of the pandemic. Many cardiovascular conditions, such as heart attack, heart failure, and stroke require urgent attention, and delaying care can result in complications or even death. These complications may also be attributed to cancellation of an elective pro-

cedure for a cardiac diagnosis during times when COVID-19 rates escalated.

Older adults who stay at home are vulnerable to their underlying cardiovascular conditions worsening and, as a result, subsequent cardiac emergencies. Several studies have shown that older adults with diabetes, high blood pressure, elevated body mass index, and cardiovascular disease are at risk for severe infection with COVID-19.

This is one reason why in the early phase of COVID-19 vaccine distribution, people over age 65 have been targeted. Some of the cardiovascular consequences of a COVID-19 infection include blood clots (deep vein thrombosis and pulmonary embo-

lism), ischemic stroke, and acute coronary syndromes (i.e., a heart attack).

Lowering your risk What can you do to mitigate your risk while addressing your cardiovascular health?

Ask about options for virtual visits, including telephone or televideo visits. Televideo visits provide an option to stay at home while connecting with a cardiology provider.

Although there is no physical examination, your provider can ascertain significant information from a visual inspection.

You can supplement the visit by using devices you may have on hand to monitor your heart rate, blood pressure, weight, and blood sugar. Share

the data you collect at home and any cardiovascular symptoms you’re experiencing with your healthcare provider by phone, video, or secure messaging systems.

Staying motivated to follow a heart-healthy diet can be challenging when meal delivery options are convenient. Focus on choosing meals that are within your dietary requirements, with a focus on fruits, vegetables, lean meats, and whole grains.

Despite limitations on exercise facilities, explore options for maintaining an active lifestyle in and around your home. Walking outside, and in-home activities like yoga and stretching, even if seated in a chair, are beneficial from a cardiovascular perspective.

Focusing on your heart health during and after the pandemic includes recognizing signs and symptoms that need prompt attention and immediate care. If you feel unwell, contact your healthcare provider to address your symptoms and get directed to an appropriate healthcare setting for further evaluation. Get a vaccine when available and remember the three Ws: wear a mask, wash your hands, and wait a distance of 6 feet from other people. n Margaret T. Bowers, DNP, FNP-BC, AACC, FAANP, FAAN, Director, Gerontological Advanced Practice Nurses Association (GAPNA); Associate Professor, Lead Faculty Cardiovascular Specialty, Duke University School of Nursing MEDIAPLANET

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If Barbra Streisand had her way, all women in America would know that heart disease, known as cardiovascular disease (CVD), is their leading killer. It kills more women than all cancers combined, yet only half of women know that, she says.

Streisand has advocated for gender equity in heart health for more than a decade, though her passion to fight gender inequality dates to her youth.

For too long, she says, there was little understanding of women’s CVD in the scientific and medical communities. A large part of the problem stems from gender disparities that span across research, diagnosis, and treatment.

“We all have been culturally exposed to the typical ‘Hollywood heart attack’ through movies and television,” says Streisand. “A man grabs his chest in severe pain and has pain running down his left arm.”

Today, we know that women with CVD often have different symptoms than men. Women’s symptoms can include shortness of breath, nausea, upper body pain, extreme fatigue, indigestion, chest pains, and others. But because these differences were unknown for a long time, sex-related disparities in diagnosis and treatment grew.

Voice for change In 2007, Streisand read about the gender inequality in medicine that spotlighted the differences in women’s heart healthcare, research, and public awareness compared

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How Barbra Streisand Is Advocating for Women’s Heart Health to men. Her realization that women were not receiving the same quality of care as men — which explained why women were dying of CVD at disproportionate rates — appalled her and made her decide to use her voice for change.

Streisand started working with Cedars-Sinai Medical Center in Los Angeles and Dr. Noel Bairey Merz, a brilliant researcher and clinician working on female-pattern heart disease. First, Streisand supported a regenerative medicine research fund, then she underwrote the Barbra Streisand Women’s Cardiovascular Research and Education Program in 2008.

Her support, advocacy, and generous philanthropic commitment resulted in the Barbra Streisand Women’s Heart Center, focused on providing lead-

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Women’s CVD Symptoms 1. Chest pain 2. Shortness of breath 3. Deep fatigue with no apparent reason 4. Upper body pain above the belly button 5. Unexplained nausea 6. Indigestion 7. L ightheadedness and dizziness with no underlying cause

ing edge healthcare to women with heart disease, developing research leading to new treatments, and training doctors about women’s CVD. Streisand soon learned that it wasn’t just doctors and scientists who weren’t talking about women’s heart health. Neither were women themselves.

“Many women don’t want people to know about their

CREDIT: CEDARS-SINAI MEDICAL CENTER

Award-winning director, actor, and singer Barbra Streisand is raising awareness about heart disease in women and how they can protect themselves.

heart issues. They do not discuss it,” says Streisand. “They seem ashamed or feel weak because of it.”

Female mice In 2014, Streisand and Bairey Merz launched the Women’s Heart Alliance (WHA), a national advocacy and education effort fighting for women’s heart health equity. They were joined by businessman and philanthropist, Ronald Perelman, Dr. Holly Andersen, and NewYork-Presbyterian/Weill Cornell Medical Center.

“To achieve heart health equity we needed to expand the research being done and to raise public awareness about heart health issues facing women,” says Streisand.

WHA aims to increase funding dedicated to gender equity

in research. For example, the number of women participating in research and clinical trials has increased significantly from less than 10 percent to one-third.

“I also fought to get female mice in clinical research,” says Streisand. “Why use male mice to study female heart disease?”

WHA’s advocacy has led to greater study of coronary microvascular dysfunction, which affects tiny blood vessels in women’s hearts with CVD. The Department of Defense is now funding research of heart disease in women and the NIH is requiring research and clinical trials to report results by gender.

Universal screening “Ten years ago, 1 in 3 women were dying of heart disease,” says Streisand. “Now, that number is 1 in 4. Women are finally being valued more.”

Now, Streisand is pushing for more research and understanding of COVID-19’s effect on CVD. Research shows that effects on the heart following COVID can be serious. People with pre-existing health conditions, such as heart disease, are at a greater risk of severe symptoms if they contract COVID-19.

Looking ahead, Streisand wants universal CVD screening for women, more funding for federally funded women’s health centers of excellence, and an analysis of the effect of sex and gender bias on federal funding for disease research.

She’s grateful for progress but laments that too many women are still dying from CVD. “We have more work to do to reach our goal of equity in the research, prevention, and treatment of women’s CVD,” she says. n Kristen Castillo

COURTESY OF SAVE A CHILD’S HEART

How Dr. Alona Raucher Sternfeld Is Saving Children’s Lives One Heart at a Time

Pediatric cardiologist Alona Raucher Sternfeld helps lead an Israeli nonprofit’s efforts to provide urgent heart care to children from countries where care is either unavailable or nonexistent.

In Zanzibar, Zambia, Tanzania, Ethiopia, and many other countries, access to pediatric heart care is often limited or nonexistent. In her time as a pediatric cardiologist with Save a Child’s Heart at Wolfson Medical Cen-

ter in Holon, Israel, Dr. Raucher Sternfeld’s work has taken her to these countries.

On her medical missions, she evaluates children in urgent need of heart care and creates strategies to get them the care they need to survive.

Dr. Raucher Sternfeld’s travels are part of her role at the helm of Save a Child’s Heart, a nonprofit organization dedicated to providing heart treatments to children, giving those born in countries with limited

access to pediatric heart care a chance at life.

“What I do, I do as an Israeli,” said Dr. Raucher Sternfeld. “I think this is part of our Jewish tradition to do Tikun Olam — to heal the world — and this is what we do here.”

Overseeing care Dr. Raucher Sternfeld, who leads the entire pediatric cardiology unit at Wolfson Medical Center, has overseen treatment of all Save a Child’s

Heart patients since 2005. She is one of many other medical team members at Wolfson who volunteer their time to treat children through Save a Child’s Heart.

Since its founding, Save a Child’s Heart has provided life-saving heart care to over 5,700 children from 62 countries and conducted more than 100 medical missions to countries around the world.

Quality pediatric heart care can be expensive and extremely difficult to access, leaving it out of reach of chidren from countries with no facilities or trained doctors. The cost of bringing a child to Israel for care is $15,000.

Growing the mission Dr. Raucher Sternfeld is excited about the new Sylvan Adams Children’s Hospital and Save a Child’s Heart International Pediatric Cardiac Center that the organization is currently completing at the Wolfson Medical Center campus. The new seven-story building, which will have state-of-the-art facilities and technologies for pediatric heart care, will help Save a Child’s Heart scale its mission to reach more children.

“The completion of the Sylvan Adams Children’s Hospital and the Save a Child’s Heart International Pediatric Cardiac Center is a game-changer,” Dr. Raucher Sternfeld said.

In order to scale the mission and save as many lives as possible, Save a Child’s Heart works with a network of teams and supporters from around the world to support the organization and raise awareness.

Dedication to care Dr. Raucher Sternfeld also manages Save a Child’s Heart’s free weekly pediatric cardiology clinic for Palestinian children.

Since its founding in 1995, Save a Child’s Heart has treated more than 3,000 Palestinian children.

They represent approximately half of Save a Child’s Heart’s patient population.

While the weekly clinic has been paused during the COVID19 pandemic, Save a Child’s Heart has continued bringing children from the Palestinian Authority and Gaza to be treated at the Wolfson Medical Center on an ongoing basis. Each week, approximately 10 new children arrive and receive the care they need to survive.

Dr. Raucher Sternfeld is the head of the pediatric cardiology unit at Wolfson Medical Center and the head pediatric cardiologist of Save a Child’s Heart. She was born in Israel but completed her high school education in St. Louis, Missouri. n Save a Child’s Heart This has been paid for by Save a Child’s Heart.

saveachildsheart.org

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