Cardiovascular disease is the leading cause of death for American women. Understanding your risk and making healthy lifestyle choices are key to preventing and managing cardiovascular disease. Read on to learn more about risk factors, impact on Black women, and ways to lead a heart healthy lifestyle.

Cardiovascular disease is a broad term that describes diseases that affect the heart and the vessels that bring blood to and from the heart - veins and arteries. Understanding the risk factors for cardiovascular disease and methods of prevention is vital, especially for Black women who are at a higher risk of developing such diseases. The statistics are alarming - heart disease is the leading cause of death for American women, and nearly 50% of African American women ages 20 and older have heart disease. Even more frightening, only 38% of Black women are aware of the fact that their risk of developing heart disease is so high. As such, increasing awareness of cardiovascular disease and its risk factors is key to reducing its prevalence within our community. 

There are two categories of heart disease to note. Acquired heart disease refers to disease that develops after birth or during one’s lifetime, while congenital heart disease describes heart disease that someone is born with. Acquired heart disease includes heart failure, valve disorders, and coronary artery disease, which is essentially plaque build-up in the coronary arteries that can decrease blood flow to the heart, causing chest pain or even heart attack.

The primary risk factors for heart disease are diabetes, smoking, high blood pressure, high cholesterol, physical inactivity, obesity, and family history of heart disease in a parent or sibling. The prevalence of these risk factors in the Black community contributes to the increased rate of heart disease amongst non-Hispanic Black women. As such, it’s crucial for Black women to see their primary care doctor yearly to check for high blood pressure, increased sugar levels, and high cholesterol. For Black women contemplating pregnancy, especially those over the age of 35, Dr. Tracy K. Paul, a cardiologist, says, “It is ideal to schedule a pre-conception visit with your primary care doctor or cardiologist to evaluate your current health status and to discuss lifestyle changes that can improve one’s health status before becoming pregnant.” 

There are many symptoms that could present that could possibly be heart disease, but individuals should definitely see a doctor if they are experiencing chest pain, if they have shortness of breath when doing everyday activities like walking or climbing stairs, if they notice swelling in their legs, or if they experience heart palpitations. “Most importantly, you need to listen to your body,” Dr. Paul says, “as heart attacks and other serious cardiac conditions do not always present the same way in women as they do in men.” 

Preventing heart disease requires integrating healthy choices into one’s lifestyle. Maintaining a healthy diet and getting regular exercise is key. A heart healthy plate should incorporate a lot of colorful green leafy vegetables, some complex starches like sweet potato, quinoa, or bulgur, and lean protein like turkey and chicken. Vegetables should make up half of the plate, complex starches should make up about a quarter, and the lean protein serving should not exceed five ounces or about the size of a deck of cards. Eating excessive amounts of salt - more than 2 grams a day - contributes to developing high blood pressure or hypertension, so individuals should get creative with their seasoning methods. Cooking with lemon, garlic, or onion can help make food more flavorful so that less salt can be used. It’s also important to avoid too many fats and focus on healthy fats like avocado or olive oil over unhealthy fats like trans and unsaturated fats. Processed foods and red meat should also be eaten in moderation. And when it comes to exercise, at a minimum, people should aim for 150 minutes of moderate exercise per week - just 30 minutes of brisk walking each day goes a long way. For people who want to lose weight, the target should be 300 minutes of moderate exercise in addition to a heart healthy diet.  “The more plant-based your diet is, the better it is for maintaining good health,” says Dr. Paul.

This piece featured quotes from Dr. Tracy K. Paul, a full-time faculty member at Weill Cornell Medicine. She practices general cardiology, critical care cardiology, and echocardiography. Her clinical interests include valvular heart disease, post-myocardial infarction care, women’s cardiovascular health, and cardiovascular health care disparities. In addition to seeing patients in her outpatient clinic, she provides inpatient care in the cardiac care unit and through the consultative cardiology service.  She is also involved in health care disparities clinical research and is the principal investigator of a project to increase awareness of hypertension disease management in Central Harlem.

Dr. Paul was born and raised in Bronx, New York and earned her Bachelor of Arts degree in Sociology from Yale University. She then earned her Doctor of Medicine degree from Columbia University’s College of Physicians & Surgeons. She completed her Internal Medicine internship and residency at New York-Presbyterian Hospital/Columbia University Medical Center. She completed her Cardiovascular Diseases fellowship training at New York-Presbyterian Hospital/Weill Cornell Medicine, where she focused on non-invasive imaging and cardiac critical care.