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An Interview with Dr. Jennifer Mieres: Why Women of Color May Face Higher Risks for Heart Disease
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The statistics are sobering. African-American women are 35% more likely to die of heart disease than Caucasian women, while Hispanic women face heart disease nearly 10 years earlier than Caucasian women. Pacific Islander women, long considered at low risk, count heart disease as their second leading cause of death. 

Obesity, high cholesterol, poverty, language barriers, physical inactivity, and lack of information all contribute to increased risk factors for women of color. A recent study found that minority patients may have poorer health because of disparities in health care, while another found that minority women were more likely to mistrust their health care provider. These are factors that make it difficult for women to gain control over their heart disease risk. 

Dr. Jennifer H. Mieres is Senior Vice President of the Office of Community and Public Health at the North Shore-LIJ Health System, co-author of the book Heart Smart for Black Women and Latinas, and a WomenHeart advisor. She says that patients need to develop a partnership with their doctors and effective communication is the key. Health care professionals need to relate to their patients in a way they can understand so they can be active participants in their care.  

Lack of trust was the main focus of a study by Michigan State University researchers, who found that almost 70% of minority women felt that medical organizations sometimes deceive or mislead their patients. While the study was specifically looking at factors that prevent women from getting breast cancer screenings, researchers found that this general mistrust translated to decreased health screenings across the board. 

Above all, minority women need to be made more aware of their risk for heart disease. Statistics show that about 68% of white women know that heart disease is the leading killer of women, compared to only 31% of black women and 29% of Hispanic women. 

Dr. Mieres also says that genetic predisposition may play a role in the greater incidence of high blood pressure and diabetes in women and men from certain cultures. African-Americans coming to the U.S. from African nations may have a difficult time metabolizing salt after adjusting to a Western diet and lifestyle vastly different from where they once lived, leading to a greater incidence of high blood pressure. Another link, not fully explored is that of diabetes in Hispanic women. Dr. Mieres predicts we will see more research in this area because Hispanics now comprise the largest minority group in the United States.  

Cultural norms also present a challenge when it comes to improving one's heart health. Traditional diets high in cholesterol, including fried foods may be tough to give up.  But they contribute to obesity and high cholesterol, two leading risks for heart disease. In obese women 20 years and older, 77% are African American; 72% are Mexican-American, and 57% are Caucasian women. And making time for exercise may not be a priority. In fact, some 60% of Hispanic women report engaging in no physical exercise program at all. 

Dr. Mieres advises minority women to begin thinking about their family risk factors for heart disease, including their genetic predisposition, in their 20s. And if there is a strong family history of high cholesterol, blood pressure or diabetes in the family, Dr. Mieres suggests making heart health a family affair by seeing a pediatrician to assess the family history and risk for heart disease. The doctor may recommend doing a baseline blood pressure and cholesterol screening on the younger members of the family. 

Aside from family history, which we may not be able to control, Dr. Mieres says we all can work toward making heart-smart changes that can dramatically lower a woman's risk for heart disease: 

• Do not skip meals; Breakfast is the most important meal of the day
• Eat 5 servings of fruits and vegetables per day
• Broil and bake foods; don't fry 
• Eat 2 servings of fish per week
• Be active every day: walk, jog, or dance at least 10 minutes daily
• Find heart healthy substitutions for your traditional favorites
• Remove the salt shaker; use spices and herbs for traditional flavors 

In these difficult economic times, women are certain to be faced with greater juggling of financial and family concerns and they may be making tough choices where resources are thin. Dr. Mieres urges women to make their own health a priority. "If you are not healthy, you will not be able to take care of your family and they need you!" 

You can purchase a copy of Dr. Mieres' book, Heart Smart for Black Women and Latinas, through Amazon or Barnes & Noble. For more information on the book, visit www.heartsmartwomenbook.com

For more information on minority women and heart health: 

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WomenHeart: The National Coalition for Women with Heart Disease is a nonprofit, 501(c)(3) patient advocacy organization with thousands of members nationwide, including women heart patients and their families, health care providers, advocates and consumers committed to helping women live longer, healthier lives. WomenHeart supports, educates and advocates on behalf of the 42 million American women living with or at risk of heart disease. Our programs are made possible by donations, grants and corporate partnerships.

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