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Barbra Streisand and Dr. Noel Bairey Merz

Q&A
BARBRA STREISAND AND
C. NOEL BAIREY MERZ, MD, FOCUS ON AN URGENT CAUSE

Q: Heart disease kills about 12 times more women annually than breast cancer. Yet breast cancer gets more research dollars and headlines. Why?

C. Noel Bairey Merz, MD: Breast cancer has had more than 40 years of successful advocacy. We need to now do this for heart disease.

Barbra Streisand: The number of women dying from breast cancer has significantly declined because of people speaking out, sharing their stories, and raising money for awareness campaigns and medical research. We desperately need the same kind of coordinated effort for heart disease.

Q: About 8.9 million women worldwide die of heart disease annually. What did you think when you first read that statistic?

Streisand: I consider myself a well-informed person, but when I first heard that, I was stunned. Very few people know this. And, until recently, almost no one talked about a disease women are dying from throughout the world.

Q: With decades of heart disease research done primarily on men, what problems does this create for proper treatment of women?

Bairey Merz: When I first became a cardiologist, women were widely viewed as if they were simply smaller versions of men. Women have paid a huge price for the medical community not knowing about important gender differences in heart disease.

We’ve now shown that women’s hearts are physiologically different than men’s, and men and women can develop a different kind of disease. Women more frequently have major arteries clear of plaque—unlike the classic male pattern—but their smaller coronary blood vessels cease to constrict and dilate properly. We call this microvascular coronary dysfunction.

Streisand: We even develop plaque differently.

Bairey Merz: That’s right. Instead of the lumpy-bumpy, fatty plaque men develop, women are more likely to streamline it onto the wall of the artery, which is invisible to the traditional angiogram. That’s why we are working to develop new diagnostic tools, so we can accurately detect small artery dysfunction.

Q: How critical is it that women educate themselves about heart disease?

Streisand: Tragically, too many women are unaware of the dangers of heart disease. It’s so important to empower women to get educated.

Bairey Merz: Each woman needs to think about her relationship with her heart. Be your own best advocate and know the warning signs. It’s not necessarily the classic “Hollywood heart attack,” but can be indigestion, nausea, or extreme fatigue.

Streisand: I learned that nearly two-thirds of women who die from heart attacks have no history of chest pain. Even if a woman does go to a doctor right away, even a well-intentioned doctor, she is often misdiagnosed.

Bairey Merz: We see women all the time who have visited doctor after doctor for years and never been properly diagnosed. These are experienced cardiologists, but they haven’t been trained to evaluate for gender-specific heart disease.

Q: Is it possible to make up for the deficit in gender-specific research?

Bairey Merz: We have a lot of catch-up. But we’ve been studying women’s heart disease and gender differences for 17 years. The good news is that this research benefits men as well. For example, our collaborators have discovered that female stem cells are better at finding injured areas of the heart after a heart attack, which may be a better jumpstart to the regenerative process.

Streisand: I love that story. When I talk to people around the country about heart disease, I tell them that even male stem cells don’t like to ask for directions. It’s a joke, but what we’re talking about isn’t funny. We can’t afford to sit back. This is an epidemic facing women, right now.

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