Heart disease is the primary cause of death in all Americans and brings particular concerns for women.
Dr. Alison Bailey is the Parkridge hospital group’s chief of cardiology and said she wants patients to know cardiovascular disease is not something they should fear, as there are many available prevention methods. However, she noted changes in the American diet over the past few decades, like an increase of calories, fat and sodium in meals, adversely affects this realm of people’s health.
By phone, Bailey discussed the importance of individuals knowing their health numbers — blood pressure, weight and more, in addition to prevention guidelines. This interview has been lightly edited for concision and clarity.
Q: What can you tell me about the importance of heart health?
A: Yeah, so cardiovascular disease is the number one cause of death of all Americans, and there’s lots of things that we can do to prevent that. We spend a lot of time … sort of sharing that information with everybody, but especially women. Women are equally as likely to die from heart disease. It’s the leading cause of death in women, but most women don’t realize that, and they still think that cancer or some other causes of death are the most likely.
Q: Why is it so prominent among women?
A: When you look at Americans, we all have a risk of having cardiovascular disease. Cardiovascular disease includes largely five things: heart disease — things like having a heart attack — stroke, high blood pressure, heart failure and diseases of the arteries make up the majority of cardiovascular disease, and when you look at our lifestyle and our genetics, both of those put us at increased risk. Now for women, we have some other sex-specific risk factors that increase our risk as well.
So, anytime that we’re pregnant, we can have specific conditions, and those are adverse disorders of pregnancy, that can cause some increased cardiovascular risk in our lifetime. So, if you’re a woman, and you have preeclampsia, gestational hypertension, gestational diabetes, all of those increase your future risk. Doesn’t increase it by, you know, three- or four-fold, but it’s higher than somebody who doesn’t have those. So it’s a great warning sign to be extremely aggressive with prevention.
Cardiovascular disease is the No. 1 cause of maternal mortality in the United States. If you look at the pregnancy period, and that period right after pregnancy, women are more likely to die from cardiovascular disease than anything else, which women don’t generally know about, because we think of cardiovascular disease as being a disease of older people frequently, because we’re used to seeing heart attacks and strokes. So prevention is really great.
Q: Speaking of prevention, what are some of the methods available?
A: There’s lots and lots of things that we can do, and our prevention really depends on our risk. If you’re any American, the things that we talk about is optimizing lifestyle, so getting regular physical activity. That doesn’t mean you have to go to a gym. Just walking is great, and we say you should try to get about 150 minutes a week, which is 20 or 30 minutes a day, of moderate intensity activity. That looks like going for a walk, and it doesn’t all have to be at one time, but you could go for a walk at lunch, and then you could take a walk with your family in the evening.
Eating a healthful diet — and diet has really changed drastically over the last 30 to 50 years in the United States — we went from, you know, largely fixing food at home to eating food prepared outside the home. That food tends to have more calories, more fat and more sodium, and all three of those adversely affect cardiovascular health. And then making sure that we know our numbers, so those numbers include our blood pressure numbers, our cholesterol numbers and our sugar numbers, and then our weight.
Seventy percent of Americans are currently overweight or obese, and that’s a strong risk factor for developing many of the cardiovascular risk factors, things like high blood pressure and diabetes and high cholesterol. We always say no smoking, so you stay away from smoking, in any of our prevention data.
Q: If you have cardiovascular disease, how do you treat that?
A: It kind of depends on which of those five categories it goes into. In general, focus on optimizing lifestyle, and that goes with whether you’re trying to prevent disease or you already have it, the rules are basically the same. If you have established cardiovascular disease, meaning you’ve had a prior heart attack or you’ve had a prior stroke, then there’s certain medications that you need to be on. Sometimes that will include things like aspirin, but aspirin is not for everybody.
I always recommend people not just start taking an aspirin, but they have a conversation with their primary care clinician to help tell them, guide them on whether they should be taking aspirin or not. If someone has told you to take aspirin, you shouldn’t stop aspirin because you read some headline in the news.
And then, you know, optimizing your numbers. If you have had a heart attack or a stroke, we’ll want your cholesterol numbers lower than someone who hasn’t had that. Our number goals change just a little bit once you have heart disease. There’s no reason you can’t live a long, healthy life if you’ve had a cardiovascular event, and optimizing lifestyle after that really increases the likelihood that you can do those things.
Q: What are some of the effects of cardiovascular disease?
A: It kind of depends on which one we’re talking about. If you have a first heart attack, some people die from that. Death is clearly one of those that we try to prevent, and then reductions in functional capacity, meaning you can’t do as many things as you used to do. Now in 2025, we have more medicines, more procedures and more opportunity to improve outcomes for people living with cardiovascular disease, and so many patients can get back to exactly the same quality of life. If you think about what are the symptoms of someone who may have cardiovascular disease and not know it, it can be things like chest pain or shortness of breath. Swelling in the legs, not being able to do the same things that people around you do, like if you went for a walk, you may not be able to, you know, do as much of the walk, or you may be trailing behind because you can’t keep up.
Sometimes it’s more non-specific things, like fatigue, not being able to sleep well. I always tell my patients it’s important that we listen to our bodies so that we know sort of when something’s not quite right. The other thing I would say is that, you know, we’ve come a long way in the world of cardiovascular disease, but there’s so much more on the horizon. That’s really important because research plays a key role in all the things that we’ve done that have improved cardiovascular health. For instance, there’s a cholesterol molecule that runs in families. It’s called lipoprotein (a), and it doesn’t have anything to do with your lifestyle, what you eat or how much you exercise. It’s all about your genes, and we’ve never had medicines to lower that.
Now, there are several medicines that are in trials, and those medicines are showing benefit. In a few years, they’ll probably make it to where I can actually prescribe them to patients because when we’re looking at a new drug, it has to go through safety testing first, ‘Is this drug safe to use in humans?’ Once we show it’s safe, we have to show that it does what we want it to do. Does it lower the lipoprotein (a), and then if it lowers the lipoprotein (a), we have to go one more step and say, “OK, it’s safe. It lowered lipoprotein (a), but now, does it prevent heart attacks and strokes and the things that we want it to do?” Twenty percent of the American population have this abnormal bile lipid, and the majority of people don’t know it.
Q: Are there any specific guidelines as to when to get your heart health checked?
A: We have lots of different guidelines for different things. If we think about something like cholesterol or lipids, it’s recommended that even children get that checked at least once in their childhood. Once you turn 18, you should get a baseline and depending on if it’s normal or abnormal, it should be checked probably no more than or no less than every five years, if it’s normal. If it’s abnormal or you’ve suffered a cardiovascular event, that’s usually something we do at least once a year, depending on the numbers. If the numbers are all good, we’ll do it once a year and then repeat it again. If the numbers aren’t good, we repeat that every three to six months until we get the numbers to where we want them.
Blood pressure, sort of similar guidelines that should be checked starting in childhood. If the numbers are normal, we’ll usually say an annual visit with your primary care physician is a great way to follow that, or health screenings, because high blood pressure doesn’t make people feel bad. That’s why they call it the silent killer. So, unless you’re getting your blood pressure checked regularly, you won’t know that it’s elevated. I tell everybody that it’s really great way to have someone you recognize as the person you go to for your annual screenings, because that’s how you know your numbers, and then if something isn’t feeling right.
That really is a primary care provider, and that person can help figure out … just do the beginnings of everything and follow you along this journey. If you need more sub-specialized care, they can get you to the right person.
Q: Is there anything else you’d like to add?
A: I think it’s important that we all recognize that cardiovascular disease is our No. 1 cause of death, but there’s many, many, many things that we can do to lower that risk. It’s not really something we should fear. It’s just having that knowledge that that’s kind of looming out there, and that if we stay on the trajectory of the standard American, we’re more likely to have cardiovascular disease, but we can change that, especially if we start with lifestyle changes.
Contact Leah Hunter at lhunter@timesfreepress.com or 423-757-6673.