hi i'm stephen jones at robert wood johnson we believe citizens need to be informed about the important healthcare issues effecting their lives. that's why we're proud to support the healthcare programming produced by the caucus educational corporation women and heart health next on caucus new jersey funding for this edition of caucus new jersey has been provided by berkeley college td bank pseg committed to improving new jersey's economy and strengthening its communities magnacare actavis in cooperation with the american medicine chest challenge new jersey sharing network dedicated to saving lives through organ and tissue donation and by kessler foundation changing the lives of people with disabilities promotional support provided by the star ledger powering nj.com and by commerce magazine

[music playing] [music playing] welcome to caucus new jersey i'm steve adubato you know the number one cause of death in women is heart disease but there are some simple changes that you can make to lower your risk and live a long and healthy life here to discuss heart health we have bobbi cecco who is in fact a volunteer for mended hearts we also have doctor subhashini gowda who is a cardiologist and electrophisiologist at robert wood johnson university hospital marjorie nolan cohn is a registered dietician finally holly boylan is a 23 year old patient who suffered from an arrhythmia i want to thank all of you for joining us to talk about women and heart health by the way an arrhythmia is doctor? it's an abnormal beating of the heart a normal rhythm beats regularly the heart

goes rhythmicaly and regularly in an arrhythmia it's an abnormal rhythm which means the heart beating either irregularly or out of rhythm okay so here's the thing now you're wondering if we could move in here this is not the typical centerpiece for a pbs television program but it is an appropriate centerpiece for this program is is a heart a model of a heart an anatomical model that you brought in. now could you see and our camera guys are the best they'll get this an arrhythmia is it something that you can pick up by looking at this diagram? no you can't? no it's an electrical activity that's recorded or if you were actually watching a live heart you could you could watch a heart beating out of sync or not beating regularly but this is really an anatomical model of the heart to show the different parts i always tell my patients i have used an analogy that your heart is exactly like your

house it's got... woah woah woah your heart is exactly like your house? by the way as you hear gems like this you realize that we have information at the bottom of the screen websites where you can get additional information heart is exactly like...? your house go ahead the reason i use the analogy and some of my colleagues have taken it of is like your house you've got upper floors bottom floors the heart has two top chambers which is the two rooms on the two top chambers? you got this upstairs you got this guys? two bottom floor rooms and it's got plumbing t's got electricity. when people the heart has plumbing? absolutely go ahead it's the beauty it's very much like your house it's got four rooms again two on the top two rooms on the bottom it's got plumbing which are all these pipes that are red and the blue pipes an you tilt it a little bit this way guys? a little bit? bob tell me what we need is this good? good guys? tell me when doctor pick it up it has got... the heart lesson. one on one.

it's got pies which are blue and red which carry the blood good blood and the bad blood the darkened blood is the bad blood which collects all the impurities from the rest of the body brings it back to the lungs get cleaned and purified and the lungs bring it back into the heart with the red pipes this is plumbing when the plumbing is affected and the pipe supply... the blood supply to the heart muscle itself has blockages by either fat or cholesterol right. plaque? or platelets... plaque got it basically it's sort of the junk that we eat sometimes that gets deposited or we have familial and genetical dispositions for these pipes to become stunted and you gotta do something to open up the pipes? exactly that's plumbing and arrhythmia not in there? an arrhythmia is not plumbing an arrhythmia is electricity oh wow so this house has electricity like plumbing it's got doors before i come to the electricity the doors are these valves that close and open close and open

and let the blood from one room go into the next room okay wow so it's got four doors for four valves four rooms the plumbing now coming to the most important part the electricity that makes the heart beat okay let me do this doctor cause i feel like this heart lesson can go on for the next hour here on public television but more information can be found sure on the website on several websites let me ask you you were born with this? yes now what's so fascinating to me is that you were born with it you're dealing with it how did it affect your life? for the most part i was still living a normal life might get tired faster if i was doing exercising or i might get lightheaded or dizzy if i'm doing it for too long but for the most part i was still able to do everything i wanted to do in a normal life okay but here's the thing you knew that you had to do something about it? yes i didn't find out until i had this until january of this year okay til january of 2014 now we're in the spring of 2014

in march what date? march 20th march 20th you had a procedure done called? an ablation yes an ablation? an electrophisiological study and an ablation an ablation? and you have a couple pictures of this and very quickly doctor before i move to the other side of the panel what is an ablation and why was it so significant? holly had a heart condition that she actually was born with she had a small hole in the heart it was repaired as a child and related and unrelated to that she developed an arrhythmia an abnormal beating of the heart which goes as an abberant abnormal form of electrical conduction within the heart she started having symptoms initially they were probably minor but later on the frequency and the duration of these symptoms started increasing am i correct holly? yes and that's when she sought help nd the ablation real quickly is? pulling of a tissue inside the heart that's abnormal and causing the abnormal beating of the heart it's a burning of it?

and it does what for you? holly? it stopped my heart beating so quickly change... you feel it? you sense it? yes yes i do you do? i could feel it my chest actually moves my whole body moves with it when my heart is beating really fast you feel it differently? yes i don't have that anymore but it's interesting this whole issue of the arrhythmia is just one heart related issue but the other reason why i wanted to do this program is because there is a misconception out there that this is heart disease is a disease for men that this is not something that effects women as much as it does and as we said in the intro it's the number one killer of women... talk about your involvement in this and from a nutritional perspective how much does nutrition play a role in the prevention effort for women well nutritionists actually consider the number one determiner of health overall number one? including heart health not exercise? not exercise

exercise is second okay but really nutrition is number one how we nourish our body is going to inherently effect every system that we have including and obviously the heart so just like plumbing what you put into again heart house plumbing just keeping with this analogy you put stuff in there that clogs up you know the pipes the pipes thank you mm hmm you're gonna have a problem it's not that simple i know so what should people what should women be eating more of and then less of? what women need to... anyone but what women need to be eating more of is actually the right kinds of fats there's a notion just like heart disease is a male problem that we need to cut out all fats and the reality is you need to eat more of the right types of fat the unsaturated mono and poly unsaturated fats which comes from what foods? that comes from plant sources like pure olive oil canola oil avocados nuts and seeds there's actually thinking

in terms of the mono and saturated fatty acids and omega 3 fatty acids when i think of that high fat fish as well as grass fed beef which can be very expensive but it's also an investment and less of? less butter saturated animal fats and less transfatty acids which are man made fats that we know for sre have been proven in clinical trials to really affect heart health and let me ask you this sorry for interrupting bobbi your organization what's it called? mended hearts why is it called that? because we talk to all kinds of people most of us visit patients who's us? how did you even get into this and then tell us about mended hearts well i had a couple of stints in the hospital and i had people came and visited me and the first time they came i really i kinda the mended health people came? yeah or mended hearts people came? visitors right and i kinda

pushed it aside anyway the second time they came my husband said you know maybe we should look into this organization maybe we should get a little educated and we did we went and a few months later i had open heart surgery and a bypass so i didn't this in the late 90's i think? 98 i had a bypass 97 late 97 i had one stent 98 would be... so how does mended hearts help you at the time? well because they gave me encouragement support they taught me what i should be doing and not doing and the biggest thing is your attitude what do you mean your attitude? what does that have you have to have a good to do with heart health? ude... oh it has a lot... it has to do with any kind of health but attitude thinking positive you can't go back over something once it's happened it happened you have to go forward look for tomorrow take one day at a time have a good attitude do the right things eat the right things do a little exercise

how does it by the way as we put up the website for mended hearts yeah how has this experience changed your life and your attitude about life? well i'll be honest with you i thought they were talking about somebody else when i was first told i was gonna have this i had i started with angina and i had no idea what angina was i thought i was having you know heartburn? heartburn or something right like reflux or something but it got so bad that i would have to sit down i couldn't do anything and i would lose circulation of my arms so i went to the doctor and while i was there i was having one and he said you're going to the hospital i couldn't believe that but you know it makes you a better person because you're more understanding once you've got... once you get a little knowledge and you have something done whatever you whatever in my case it was surgery right yeah you're better do you eat differently? excuse me? do you eat differently today? yeah i cheat once in a while

[laughter] i'm honest with you i'm honest with you that's normal but you know i even tell people when i visit yes watch what you at but once in a while have that little thing that you want just don't do it every day yes moderation moderation exercise a part of your work? well it should be bigger lk... i did do a lot of exercise you do more than... oh you did? i did before i had my heart problem i used to go to aerobic class every day well about three days a week woah hold on wait a minute now what's so interesting to me then is you're making it clear that even if a women exercises on a regular basis absolutely even if a woman eats the right things it helps but there's certain risk factors some of them genetic doctor yes bobbi's talking about doing a lot of the right things a lot of genetic... steve i think what... you can't guarantee anything? yeah yeah jump in i didn't want to interrupt but bobbi gave a very classic actually typical story with no prompting she said i didn't think it was her heart the statistics show that women present very atypically

compared to men with heart disease they present atypically? completely atypical men versus women go ahead men... so men versus women very interestingly and very realistic important statistics are men present typical elephant sitting on the chest heavy on my chest tightness sweating diaphoretic left armpit women can come in with sinusitis have come in with heartburn sinusitis? i've had women patients come in to the er for completely unrelated symptoms and have actually been diagnosed with an acute heart attack a lot of the women and a lot of the heart disease in women also get diagnosed in an outpatient setting where it's an abnormal stress test ekg that's abnormal or an echo choreogram the tests that are abnormal but presenting to the er completely atypically that's women so therefore as we put up information on the website it is important that women know what those warning signs are right and that they are not the same

exactly as men exactly the same as men and also we need to be aware of those quickly and the most common thing is women most often present with just not feeling good or short of breath they can't cary that same laundry basket that they were carrying easily before they can't run around the kids or do something they were doing and one of the very interesting statistics about women all of us do it we take more care of the family more than us so do you... we put everything about and beyond in this there's a study and hispanic women especially that a hispanic woman is most prone or tends to more take care of the whole family than go to the doctor herself so do you think women for several decades sorry for interrupting do you think women are potentially more susceptible to some of these issues because they are less aware concerned right and focused on their own health? absolutely they have well known... so therefore by the time they're dealing with it absolutely it... not that it's too late but they could do something earlier on? yes absolutely there are a lot of really simple lifestyle changes that any woman could start to do right away but

may not realize it now go ahead they're watching right now on public broadcasting what can women watching right now want to give themselves the best chance to have a long and healthy life? well one of the first things you can start to do easily that is no cost whatsoever is exercise the current reccommendations to improve heart health are about five days a week thirty minutes per day that can actually be broken up into ten or fifteen minute segments so someone says quote i don't have the time you say? ten minutes increase your heart rate and this is not intense exercise it's amoderately high heart rate you should be able to not hold a conversation with the person next to you if you're walking have to take a couple of breaths every few words but it's not highly intense so you don't have to do one of those infomercials where you know people are totally transforming their bodies in six weeks? no that's not what we're talking about? no no this actually doesn't... isn't necessarily associated with weight even it's a matter of your heart's a muscle so and you're strengthening and conditioning the heart holly listen

how old are you right now? 23 [laughter] she's a baby to very young women i know you said you just referenced her she's a baby but she's a baby who's experienced an awful lot what would you say to women out there who are in their 20s early 30s who say not me it could never happen to me you say? i would definitely tell them to be aware of what's going on with themselves that they feel anything wrong to definitely get it checked out to not wait and have something else possibly happen if they're waiting too long and to stay physically fit and eat well and try to exercise just to keep everything okay how has it changed you? it makes me more aware of what could go wrong and it just pushes me to want to do more with myself and i personally want to get into the heart field on my own really? to start working with others yes what do you mean? i want to be a cardiac stenographer i want to help do ultrasounds with the heart on other people and share my story with them it goes back to what you said about attitude attitude absolutely

you could decide that's it i got a tough break in life born with a hole in my heart life's unfair whatever you choose to see it differently? yes cause i had so many good experiences with doctors as i was growing up since i did have open heart surgery at two months old and then i had this surgery just a month ago it's just... i've had so many doctors with good experiences that i want to be one of them and what i would like to bring back is that bobbi's story is more of the women developing heart disease as cardiovascular disease whereas holly is more genetic and familial yes she's born with it or sometimes the kids are born with it but it doesn't act up until middle age it's an arrhythmia which is an electrical issue which sometimes can be related to the plumbing but in holly's case it was not plumbing it was something an abnormal electrical tissue she was born with yeah which decided to act up yup a few months ago for her a couple interesting things that we need to bring... real quick cause we only have

so much time... go ahead... bring about for women and heart disease is that every year more women than men die of heart disease but we are more aware of men the statistics are that one of every three women die of heart disease one of every three women? one of every third woman die of heart disease the other interesting statistic is that in the united states about 43 million women are affected with hea... 43 million women are affected with heart disease but since 1984 every year more women than men have died of heart disease combining all the causes of death in women the number one cause of death not just disease number one cause of death is heart disease and if you count breast cancer which we have a great campaign against 1 in every 31 women die of breast cancer but 1 in every 3 women die of heart disease in terms of attention media attention public attention and we have great

respect for our colleagues who cover and focus on breast health and we have as well but there's a dramatic difference in terms of the amount of attention and focus on breast health versus heart health i also think though the number one thing for women if they... not that it's either or by the way they should get a physical every year talk about that sorry i interrupted you a physical every year they should get absolutely because then you can catch things before they become monsters you know what do you mean? well a lot of women they never go to the doctor very well said you know so what are they looking for? well anything just have a... i mean a woman says i don't want to go home and find out something i gotta deal with you know i'd rather not know well see that's the problem a lot of people feel that way and they don't want to know well it's too late and then what's the problem with not wanting to know? and then they cry when it's too late you know and sometimes when women have presented like holly with racing hearts they've been misdiagnosed as panic attacks or anxiety attacks right yes jump in another thing i just want to oint out is that i think this is true for adults men and women

is that when there's some sort of problem in their prescribed medication it sort of you know does it mask it? it masks it and people think okay i'm on... my cholesterol's fine now because i'm on medication that's right and that's not true but don't we want to hold on the dilemma here is don't we want to take advantage of modern medicine take those medicines to monitor our cholesterol you know yes but you have to go to a doctor to have that monitored that's right you can't monitor it yourself you can't monitor yourself and one of the things i think one of the things i encounter so often with clients that come to me is that they don't realize they have heart disease they don't realize their cholesterol is high they don't realize that they're prediabetic or even diabetic which is closely related to heart disease because they are on medications and their bloodwork is normal because of the medication so the risk factors include diabetes? diabetes high cholesterol hypertension or high blood pressure as well

overweight? overweight and obesity smoking? smoking stress stress? life after a heart attack you've told our producers well i didn't have a heart attack i'm sorry life after a heart event right if you will procedure whatever it is right you've said that a stent and surgery is not a cure no and you know today more people get stents than they have open heart surgery and they think they're automatically cured what are they? what are...? they're not cured but what are they? oh no it's a band aid it's a band aid cause nine out of ten oh i shouldn't say that oday they're are a little better the stents they're coated so they do last a little better in my case i had two stents they were metal i had a one inch and a five inch and they just clogged again so i ended up having to have surgery but listen i want to be clear though the stents are better than ever before absolutely they may not be a cure but they are what doctor? they are called drug alluded stents or coated stents

right they're coated they're pieces of metal that you put in these pipes to open them when they have the blockage a pipe can have a blockage basically a pipe is straight or it can have a constriction so we put a piece of metal and open up the blockage but they can close up again mm hmm and like bobbi said bobbi has great anecdotes and experience because she's lived through them and like she said when they open up actually the symptoms can be worse than what she had initially which is why you have to be as vigilant as ever mm hmm about the diet about exercise about managing stress follow ups physician follow ups before we get out of here i just... i need to ask this question for women who are challenged from a socioeconomic point of view women frankly who have a hard time because they live in communities where it's hard to get fresh fruit and vegetables and healthier food the kind you described before for women who are more stressed because the economic realities in their life and the other situations in their life frankly are more stressful than others because economics and

the social conditions in which they live are more stressful what do we say to them? because everything we're talking about not everything much of what we are talking about does involve having access to information great healthcare good food all these kinds of things it is somewhat related to socioeconomic factors no? mm hmm absolutely yes right but they do have to go through a whole food market to be healthy right you pick the right making healthy choices of the choices you have is the key attitude is the next key to make sure you make your... keep your physician appointments so in your mind there's no excuse for anyone regardless of their economic position in life where they live what community they live in what their economic status is to help themselves a woman helping herself right protect herself well i think you control your body and you control your mind so it's up to you what you

want to do with it there is help out there for people even in low income places we have all these farmer markets and things that they can get food cheaper but they have to but you have to be proactive about this yes and they have to cook you know today if you look at the majority of women chopping they work a lot of them they work i understand that if you're lucky enough to have a job go ahead so they go shopping and they buy all this premade and that's all they eat that's why the kids all they want is chicken mcnuggets macaroni and cheese because the people don't don't take the time which is not good for our plumbing by itself go ahead and one minute left you can eat better without a higher cost right it's about a few substitutions olive oil for butter lentils and beans which you can get dried or panned and that's actually less expensive than most meats you want seasonal produce and frozen vegetables cause you get protein out of those beans right? absolutely

you get the protein and they're high in fiber which helps lower cholesterol and then whole grains brown rice versus white rice whole grain pasta versus white pasta choices then these things there's no difference in cost well i'll tell you what you are a terriffic group of women who are advocates who are experts who are people who have experienced it on your own and i have a very strong sense that you've helped an awful lot of people in this last half hour on public broadcasting i want to thank all of you and at 23 we particularly wish you nothing but the best thank you all the best the preceding program has been a production of the caucus educational corporation celebrating over 25 years of broadcast excellence and thirteen for wnet njtv and whyy funding for this edition of caucus new jersey has been provided by berkeley college td bank pseg magnacare

actavis in cooperation with the american medicine chest challenge new jersey sharing network and by kessler foundation transportation provided by air brook limousine serving the metropolitan new york new jersey area caucus new jersey has been produced in partnership with tristar studios hi i'm peter rooney in 2006 i lost my father to renal disease he was on the waiting list for a new kidney but did not receive one in time unfortunately so many like my father have lost their lives while waiting for a life saving organ. at new jersey sharing network we're committed to saving and enhancing people's lives through organ and tissue donation and by informing people about this important decision because you can make a difference and save a life

captioning sponsored by macneil/lehrer productions >> sreenivasan: rocket-fire and air-strikes in gaza grind to a standstill as israel and hamas agree to an open-ended cease- fire. good evening, i'm gwen ifill, judy woodruff is away. also ahead this tuesday, burger king's mega-purchase of a canadian restaurant chain, and the relocation of it's headquarters to ontario, here the corporate tax rate is lower. plus, our series on "rethinking college," zeroes in on the trillion dollar student debt burden >> we've traveled around wisconsin, and we've talked to people of all ages about their student loan debt and it's soul crushing for them, they're saying all i wado