Taking It to Heart: Laura Bush Speaks Out About Heart Disease and Women

First lady Laura Bush is vibrant in a black pantsuit adorned with a tiny red enameled pin in the shape of a woman's dress, the symbol of the national Heart Truth education campaign. She's just blocks from the White House today, at George Washington University Hospital, explaining to a group of patients and doctors how she became involved with Heart Truth after medical experts presented her with some startling facts about women and heart disease.

"I was surprised that heart disease was the number one killer" of women, Bush says. "I just didn't know. I assumed cancer was. And I knew if I didn't know, most women probably didn't know either."

The first lady has spent five years delivering the campaign's message that heart disease affects women as much as men, that a woman's heart attack symptoms can be very different from a man's and that women need to know if their family history or their lifestyle puts them at risk for heart disease.

During her hospital visit, Bush stopped to talk with a female heart patient and took part in a roundtable discussion with former heart patients and their doctors.

Later, in an interview with the AARP Bulletin, Bush stressed the do's and don'ts of heart health—do lose weight, do eat healthy foods and exercise, don't smoke. Her soft Texas drawl and easygoing manner transformed what could be a finger-wagging lecture into something more like a conversation with a concerned friend.

Bush says that since turning 60, she's begun hearing about former school friends who have had heart attacks.

"The first of the baby boomers think that we're perfectly healthy, but of course everyone needs to know what their risk factors are and treat them," she says. Once women turn 55, for example, age increases the odds for cardiac disease—so do high blood pressure, high cholesterol, diabetes, obesity, smoking, inactivity and a family history of heart disease.

Bush urges women to take control of their health. Heart disease, she says, is "particularly pervasive in women of color." Diabetes, high blood pressure and high cholesterol are more prevalent in African American and Hispanic women than in other women. "If you have these" conditions, Bush says, "you need to check with your doctors."

Having even one risk factor doubles the chance of developing heart disease, experts say, and having three or more increases it tenfold.

"I urge women to call your mothers and sisters and…get those screenings," Bush says.

Her message is especially timely. Two new studies released last month at the International Conference on the Prevention of Dementia, in Washington, reaffirm the link between heart disease and Alzheimer's disease. Researchers point to growing evidence that the risk factors for heart attack and stroke also increase the chance of cognitive decline. Treating those factors—lowering high blood pressure with medicine, for example—may lower the chances of developing dementia or slow its progression. What's good for your heart, the experts say, is also good for your brain.

And yet, a new RAND Corp. study of 50,000 men and women covered by Medicare or managed care plans finds that women with heart disease and diabetes are still less likely to receive the same kind of routine medical care—for example, being prescribed ACE inhibitors or other drugs for chronic heart failure—as men with the same conditions. "These are low-cost treatments that can forestall serious health problems…and women with diabetes and heart disease are not receiving them as often as men," says Chloe Bird, lead author of the study, which was published in the May-June edition of Women's Health Issues.

The study found that among Medicare enrollees, women were 22 percent less likely than men to get cholesterol drugs and care guidance. Those with diabetes were 19 percent less likely to have their cholesterol numbers within recommended ranges.

Still, since the first lady first learned in 2002 that heart disease is the leading killer of women, awareness is up. According to the American Heart Association, in 2000 only 34 percent of women knew it was the biggest threat; today that number has grown to 57 percent. And there's evidence that they're learning the unusual signs of a woman's heart attack.

"The classic symptoms of a heart attack—the crushing chest pain we see with people on television or in movies—are not always the symptoms that women have," Bush says, ticking off the more likely symptoms, from fatigue to a burning feeling on the back.

She again brings up the value of good nutrition. "Eating healthy meals," she acknowledges, "is very easy for us," thanks to White House chefs. "It's harder when you're doing your own cooking, for sure.

"For older people," Bush says, "at this point in life you realize it really is important to have healthy foods. But the problem—and I see this with my mother now—is that she doesn't cook because she's the only one. She always cooked when she was fixing meals for my dad—the really healthy foods. But now that she's alone, she's less likely to cook a meal for herself."

She urges older people to get together with friends for meals. "A healthy diet," she says, "is a very, very important part of good health as we age."