Heart Health
When facing a difficult decision, we’re often told to listen to our hearts. In terms of our bodily health, the heart also deserves our attention! The heart is strong, flexible, adaptive, and central to our well being. About the size of a fist, it is a muscular organ consisting of four chambers, valves, an electrical system, and blood vessels. The electrical network of cells controls the heart’s pumping action, circulating oxygen-rich blood throughout the body. We already intuitively know a great deal about our hearts. We can feel them working just by taking our pulse, feeling our heart race after exercise or pound when we are stressed. Hearing the rhythms of another person’s heartbeat can soothe us.
Gender and other aspects of our social identity profoundly affect our health, including the state of our hearts. Not only biological factors but also cultural expectations, sexist assumptions, and biased practices all influence who develops heart disease, whether there will be a correct diagnosis, and whether treatment will be effective.
Cardiovascular disease is one of the leading causes of death and disability for women throughout the world. It is the top killer of American women, causing about one in five female deaths In the United States. Heart disease is the leading cause of death for Black and white women in the United States and it is as deadly as cancer among American Indian and Alaska Native women. For Latinx and Asian or Pacific Islander women, only cancer surpasses heart disease as the leading cause of death. And large numbers of women suffer from heart disease and disability, and related conditions, even when those conditions aren’t immediately fatal.
From palpitations to heart failure, women are more often misdiagnosed and undertreated relative to men. Racial and class disparities in diagnosis and treatment are nearly universal in the U.S. These disparities are due in large part to systemic sexism, racism, and classism in the healthcare system. For example, women with heart attacks are more likely than men to suffer from missed or delayed diagnosis. There are many reasons for these misdiagnoses. The bias of the medical care provider, or the patient, may lead them to dismiss symptoms. And female-bodied people often present with different symptoms than male-bodied people do. The menstrual cycle, pregnancy, and menopause, for instance, can affect our hearts. In addition, research studies and testing guidelines have historically relied on data from cis-male patients. As a result, certain tests, such as stress tests, are less accurate in diagnosing women. Newer guidelines and standards are addressing this issue but it remains a widespread problem.
Women of all ages are exhorted to lose weight and “be healthy,” but we get conflicting messages about what is healthy and how to get there. Most of these messages do not actually help us to keep our hearts healthy. Rather, they may be based in diet culture, fatphobia, and sexist prejudice, rather than in medical research or best practices. Our cultural phobia about being fat can convince women to adopt methods for getting thin that are in fact bad for our hearts. Weight loss approaches such as diet pills, crash diets, fad diets, yo-yo dieting, bulimia, and anorexia all harm our heart health.
So far, when studies of heart health consider sex or gender at all, they usually use a binary framework of men and women as two opposing categories. That is, current resources on heart health rarely integrate a more complex, non-binary perspective on sex or gender. While studying women is a critical step in the right direction, we need heart research that covers the whole spectrum of how we live and identify. Our Bodies Ourselves is deeply committed to updating this section as new, gender-expansive research and resources emerge.
Our resources explore questions about women, gender-expansive people, and their heart health. What is actually known, and evidence-based, about women’s cardiovascular health and how to maintain it? How do diet and exercise actually contribute to heart health or worsen cardiovascular problems? What other forms of prevention are most effective for women at different stages of our lives? How can we resist exhortations to “diet” and “lose weight” that are not beneficial to our health? And how can we best advocate for ourselves and our loved ones?