Beyond the red dress

Think “pink” in relation to health issues, and breast cancer immediately springs to mind. Think “red” and… well, many people probably will recognize it as the symbol for women’s heart health, especially if it happens to be February, but plenty of folks might come up blank.

Are we so conditioned to fear breast cancer that we can’t fully recognize or appreciate the risk that heart disease poses to women’s health? It’s an intriguing question posed by cardiologist Dr. Lisa Rosenbaum in the New England Journal of Medicine last week.

In the past decade the American Heart Association’s Go Red for Women campaign and similar educational efforts have greatly increased women’s knowledge about heart disease, Dr. Rosenbaum writes. More recently, though, the gains have mostly leveled off. Gaps in knowledge also persist among minority women, who often are at higher risk of heart disease.

Dr. Rosenbaum wonders: What’s needed here – more facts or a greater effort to address women’s emotions?

There seems to be something visceral about breast cancer that taps into women’s fears in ways that don’t happen with heart disease, Dr. Rosenbaum writes. She speculates that maybe it’s connected with female identity and thus resonates with women very deeply. Against this, perhaps it’s harder for women to really engage with heart disease, she suggests.

Dr. Rosenbaum writes:

Have pink ribbons and Races for the Cure so permeated our culture that the resulting female solidarity lends mammography a sacred status? Is the issue that breast cancer attacks a body part that is so fundamental to female identity that, to be a woman, one must join the war on this disease? In an era when women’s reproductive rights remain under assault, is reduced screening inevitably viewed as an attempt to take something away? Or is the issue one of a tragic story we have all heard — a young woman’s life destroyed, the children who watch her suffer and are then left behind?

On the other hand, what is it about being at risk for heart disease that is emotionally dissonant for women? Might we view heart disease as the consequence of having done something bad, whereas to get breast cancer is to have something bad happen to you? In a culture obsessed with the “natural,” are risk-reducing medications anathema to our vision of healthy living? Or are we held up by our ideal of beauty? We can each summon the images of beautiful young women with breast cancer. Where are all the beautiful women with heart disease?

There’s certainly food for thought here. One way of encouraging women to rethink their perception of heart disease risk might be more emphasis on the message that heart disease isn’t always caused by unhealthy lifestyles, Dr. Rosenbaum suggests. Maybe women need to be reminded that a “natural” approach isn’t necessarily better than taking medication to reduce their cholesterol or blood pressure.

And maybe, she suggests, “we can try to move beyond disease wars toward the creation of communities of women in which stories about living with heart disease are as celebrated as stories of surviving breast cancer.”

Here’s a place to start: a collection of survivor stories from WomenHeart, a national coalition for women with heart disease. And from the excellent Heart Sisters blog by heart attack survivor Carolyn Thomas, here are several first-person stories from women who describe openly and frankly what their heart attack was like.

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