With thanks to my genetics—not to mention my husband’s six-times-stented coronary arteries—I was always open to learning any new information I possibly could about our hearts. So I thought I knew pretty much everything there is to know about getting on, or back on, the beating path. And who among us is most vulnerable or at risk for heart disease.
But here’s something I didn’t realize: One in three Latina women have a form of cardiovascular or heart disease, and yet studies suggest that Latino adults are the racial and ethnic group least likely to visit a doctor’s office! Just like their varied national and cultural backgrounds, the reasons for this will vary. Research has identified that in general they may include a strong preference for cultural or family remedies, distrust in the medical system, language barriers, lack of time, or even some combination of all. And when it comes to heart failure, due to significant health disparities and inequities, Latina women have even worse health outcomes. That’s why Boehringer Ingelheim and Eli Lilly and Company recently launched Cuide Su Corazón, an initiative that aims to combat health disparities and inequities for Latina women with heart failure.
Cuide Su Corazón, the Spanish-language extension of Hear Your Heart, is grounded in research and data that shows significant health disparity and equity issues exist in the treatment of heart failure for women, especially Black and Latina women. This program is a call-to-action for women with heart failure, especially Black and Latina women, to prioritize their health and feel confident in asking for the resources they need to feel their best while managing their condition.
I was interested in learning more about the program. And I came upon my best sources of information. Please meet Lupe, a woman living with heart failure, and Dr. Johanna Contreras, MD, MSc, FACC, FAHA, FASE, FHFSA, Associate Professor, Icahn School of Medicine, Director of the Ambulatory Heart Failure Network and Director of Diversity at Mount Sinai Health System. Here’s what they have to say:
JWM: Lupe, why did you get involved in the Cuide Su Corazón campaign?
Lupe: I joined Cuide Su Corazón to show other women, especially Latina women, just how important it is to listen to what your heart needs and take an active role in your care. My heart failure diagnosis is relatively new to me, and I am still figuring out how to be my own heart success advocate, but I know that the changes I’ve made so far have made huge differences for me and my family. I am learning to lean on my support team, to voice any concerns to my doctors and to adjust my lifestyle, all while staying true to myself and my culture. I want to make sure other women with heart failure understand the importance of asking for support when you need it and putting your own care first, as this is something that I’ve had to adjust to as well.
JWM: How about you, Dr. Contreras?
Dr. Contreras: I got involved with Cuide Su Corazón because it resonates with me both professionally and personally. When I began practicing cardiology in New York City in 2011, I was the only Spanish-speaking female cardiologist in my department, and I saw first-hand the impact that language barriers could have on care. I have addressed these types of barriers throughout my career – I work at community-based clinics, I’m a member of several Hispanic associations and this past year we founded the National Hispanic Cardiovascular Collaborative with the American Heart Association. Through my research, I actively work to promote diversity and representation in healthcare among minority groups at all levels.
JWM: Lupe, can you tell us a little more about your heart failure story?
Lupe: About seven years ago I visited my primary care doctor and received an EKG test as I had a history of high blood pressure and wasn’t feeling well at the time. The doctor didn’t find anything, but I continued to feel dizzy, only to be told to drink more water. I was always active and would go to the gym until one day I felt like my heart was hitting a wall – almost like it wouldn’t pump anymore. That feeling never really went away, so finally about a year ago, my cardiologist ordered an echocardiogram. We didn’t talk about the results, but when I picked up the medication they prescribed, I saw the words “heart failure” on the package. It was scary, but seeing those words answered seven years of questions in an instant. I gave up my job as a building inspector for a less taxing desk job because of the physical impact of my condition. And although I’ve had to make other changes in this new chapter of life, prioritizing my heart health has helped me to successfully manage my condition.
JWM: Doctor, what advice do you give to women looking to take a more active role in their heart failure care?
Dr. Contreras: I recommend women living with heart failure understand the importance of putting their heart failure care first. I want to remind them that it is crucial to make time to care for themselves so that they can continue to care for those around them. Take the time to prioritize heart health by making lifestyle changes, managing mental health, securing and engaging with the right care team and ensuring associated conditions are managed properly. Treating heart failure is complex, and for Latina women specifically, health is often intertwined with culture. I am here to help women understand that prioritizing their personal health can still coincide with their existing lifestyle and does not have to change who they are. I like to tell my patients “You have the disease, the disease doesn’t have you. You can choose your own path.”
JWM: I like what you said, doctor. “You have the disease, the disease doesn’t have you.” So what advice do you give women vis-a-vis their hearts?
Dr. Contreras: I encourage all women with heart failure to visit HFHearYourHeart.com or CuideSuCorazonIC.com to access additional information about the program, as well as resources that provide educational information and tips for managing heart failure.
JWM: Lupe, why is it important for women with heart failure to have the right support in terms of their care teams?
Lupe: As women, particularly Latina women, we tend to suffer in silence and prioritize caring for those around us instead of ourselves. Heart failure can be hard to manage, and we’ll always have good days and bad days. That said, it’s important for women with heart failure to make sure we have the right support network in place to help us feel our best. This support could come from family, friends, doctors or advocacy groups that bring together women in similar situations to help each other with their heart health. Personally, I have great friends and family who look out for me, and I’ve also joined an online heart failure support group. It’s been so important for me to see other women who are going through a similar situation and who have come out on top in terms of successfully managing their diagnosis.
JWM: Doctor, what are some reasons Black and Latina women face significant challenges in getting the best care for their heart failure?
Dr. Contreras: Black and Latina women face many unique challenges and barriers that prevent optimal care. A variety of social determinants of health, including health literacy, socioeconomics, environmental influences and limited access to care can contribute to poor health outcomes. In terms of heart failure specifically, Black and Latina communities have higher rates of diabetes, obesity and high blood pressure which can lead to heart diseases, including heart failure.
JWM: Do you feel there is a significant health disparity and that equity issues exist in the treatment of heart failure for women, especially Black and Latina women?
Dr. Contreras: I do. Most notably: Black and Latina women living with heart failure are less likely to be admitted to specialized cardiology units, and Black women with heart failure have a greater mortality rate than white women. Hispanic women on average are more likely to develop heart disease 10 years earlier compared to non-Hispanics, and yet only one-third know it is their greatest risk of death. Additionally, heart disease, which includes heart failure, is the second leading cause of death for Latina women. As a Latina, I understand the cultural nuances that can complicate and, in some cases, prevent proper care. It’s important to me to lend my voice and expertise to Cuide Su Corazón to help women understand that it’s possible to prioritize your personal health while still honoring who you are.
JWM: Thank you Dr. Conteras for your advice and Lupe for your inspiring story. All in all, it is never too late for any of us to listen hear our hearts and take the appropriate steps to begin to feel Better Than Before.
Visit HFHearYourHeart.com for English-language content or CuideSuCorazonIC.com for Spanish-language content.
