ATLANTA — Shirley Hughes, owner of Sweet Cheats bakery in Atlanta, was 38 years old when a routine electrocardiogram landed her in the hospital for 10 days.
Other than a heart murmur that had been detected during her days as a young athlete, she had no indication that anything was wrong with her heart.
A former bodybuilder, Hughes appeared healthy on the outside, but doctors told her she had the heart of a 65-year-old beating in her chest.
Her aorta, the major artery carrying blood from the heart, had enlarged, leaving the artery walls paper thin. The condition was possibly a hereditary condition unknowingly passed to her by her mother.
"Don't worry, we can fix this with surgery," said the cardiologist attending to Hughes.
Hughes thought the surgery was something she could schedule later. The doctor quickly disabused her of that idea.
"She said, 'This is not something we are going to schedule. We are taking you to the ER now,'" Hughes said.
Two days earlier, she had played a doubleheader with her softball team. Now she was headed to emergency surgery. Hughes was in shock.
"I was thinking about everything else except my physical being," said Hughes, 45. "It was a long road to get to where I am right now."
Every February, designated American Heart Month, Hughes likes to share her story with other women as a call to action — the effort of one individual to combat a disease that kills one in three women and is the leading cause of death in Georgia.
I feel as if I've been writing stories about the incidence of heart disease in women for two decades. And if I haven't written those stories, I've read them. But things only seem to get worse.
The global death rate due to cardiovascular disease, which includes stroke, hypertension, heart disease and other heart conditions, has been on the rise for 30 years, according to a recent report in the Journal of the American College of Cardiology. As with many of the major health concerns that lead to death, there are disparities based on income, race and gender.
Among women in metro Atlanta, 57% of Black women have cardiovascular disease as do 43% of white and Hispanic women. Heart attacks are on the rise in younger women, yet most Gen Z and Millennial women have no idea heart disease is the greatest threat to their health.
For women, hormonal factors surrounding pregnancy, birth control and menopause can all pose additional risks to cardiovascular disease, though smoking and hypertension are the leading causes. From 2008 to 2018, the death rate attributable to high blood pressure increased by 27%.
One of the challenges is symptom awareness. Cardiovascular disease can look very different in women than men. But even when the disease is recognized, women face additional barriers to treatment. Women are less likely to receive CPR from bystanders, less likely to be resuscitated when in cardiac arrest and once at the hospital, women experience 20% longer wait times than men to receive care.
"The big piece for us is awareness. When we are feeling things in our bodies ... we make excuses sometimes. But if you are aware of the signs and symptoms, you will be able to get assistance sooner," said Carla Smith, Vice President of Health Strategies for the American Heart Association in Georgia.
Stress, said Smith, is a big part of why we see such an increase in cardiovascular disease among women. "We are the caretakers of our family and children in a lot of cases. That additional stress on our bodies affects the heart." This was particularly noticeable during the pandemic when higher increases in blood pressure were measured among women for both systolic and diastolic blood pressure, according to new research published in December in the American Heart Association's flagship journal Circulation.
"The conversation needs to be elevated because we don't talk about it enough," Smith said. "I always tell women to talk about it with other women."
It may also help to participate in programs designed specifically to provide heart health screenings for women, such as those offered at hospital systems in metro Atlanta. The programs, at costs ranging from $50 to $100, provide preventative assessments to help catch potential heart issues before they start.
Experts say that supporting education and lifestyle changes can reduce the risk of cardiovascular disease among women by 80%.
That's an investment worth making.
