JAMA Podcast: Barbra Streisand and Noel Bairey Merz, MD, Advocate for Women
Actress, singer and activist Barbra Streisand has teamed up again with Noel Bairey Merz, MD, director of the Barbra Streisand Women’s Heart Center in the Smidt Heart Institute at Cedars-Sinai, to warn women and their physicians about how women experience ischemic heart disease differently than men. The duo shared their perspectives with the Journal of the American Medical Association (JAMA) podcast, JAMA Author Interviews.
The podcast comes on the heels of a review article published today in JAMA authored by Bairey Merz and colleagues in the Smidt Heart Institute, including cardiologist Janet Wei, MD, assistant director of the Barbra Streisand Women’s Heart Center, and Susan Cheng, MD, MPH, MMSc, director of Public Health Research and director of Cardiovascular Population Sciences at the Barbra Streisand Women's Heart Center.
In the review article, Bairey Merz and authors explain how physicians should evaluate female patients who complain about chest pain.
Frequently, standard tests show that women with ischemia – chest pain and abnormal stress testing – do not have clogged arteries, as men with heart disease often do. Too frequently, these female patients are told their hearts are fine and their symptoms are imagined.
Therefore, the review paper recommends physicians use a new diagnostic protocols to see if those female patients have coronary microvascular dysfunction, which is abnormal blood flow in the tiny vessels in the heart. Coronary microvascular dysfunction can occur in males but is relatively more prevalent among women.
Both the disparity in how women are diagnosed and treated with heart conditions like ischemic heart disease is why Streisand partnered with Bairey Merz more than a decade ago.
“It was 2007 when I discovered the staggering number of women who die from cardiovascular disease and that so few resources were put toward women’s heart health,” Streisand told Edward Livingston, MD, Deputy Editor for Clinical Content of JAMA and host of the podcast. “One in three women die of heart disease and stroke, whereas one in 31 women die of breast cancer. But the United States spends almost 10 times more research funding on women's cancer than heart disease.”
As Streisand explains, cancer research funding shouldn’t’ go down, but “heart disease funding needs to go way up, to help the number of women that are affected.”
Cardiovascular disease is the No. 1 cause of death for women in the United States and two out of three American women have at least one risk factor for heart disease. Equally as alarming, 12 times as many women die of heart disease every year as die from breast cancer.
In addition to increasing funding for cardiovascular disease in women, Streisand also suggests more women are needed in clinical trials.
“How can we optimize diagnostics and therapeutics for women if we're not including more of them in our research,” Streisand shared. “Women have different plumbing, smaller hearts, and narrower arteries. And because of the lack of research, they are often misdiagnosed or under-treated.”
When asked by Livingston how Streisand stays motivated to spread awareness about women’s heart health, her response was simple.
“Improving heart health is everybody’s responsibility,” said Streisand. “Because cardiovascular disease is everybody’s problem.”
Click here to listen to the complete JAMA Podcast.
Read more about women's heart disease from Discoveries magazine: Picture not Perfect.