By Ken Amundson (https://bizwest.com/author/kamundson/)
LOUISVILLE — Health care professionals recognized decades ago that medical research exhibited a bias toward men at the expense of women. The result: Treatments advanced the health of men while ignoring the gender differences that women exhibited.
When it comes to cardiac care, the acknowledgment of research shortcomings is starting to make a difference, according to Kim Riemer, a nurse practitioner with AdventHealth, the organization that operates AdventHealth Avista in Louisville.
“There’s a lot of push to recognize young women in their childbearing years to manage the risk that they face,” Riemer said in an interview with BizWest.
And the same applies to older women. “Women tend to develop symptoms later than men. Shortness of breath (as women age) may be the symptom and not chest pains. Women have more small vessel problems, where stents won’t work, so we have to be more creative to fix. Women also have more false positives with stress tests and may need imaging as well as the treadmill,” she said.
Riemer, a 23-year veteran of cardiac care, said that in the past five to 10 years she has seen more sudden coronary issues with young women than in the past. It’s not fully understood.
She noted a new condition called “sudden coronary dissection” of blood vessels. Instead of a blockage in the blood vessel, blood clots form between two layers of coronary vessels, which constricts the vessel and reduces blood flow.
Women present in the emergency room with chest pain. CT scans and angiograms can show the issue.
She said it is uncertain what is causing the malady — it could be genetic, and it does show up more frequently during pregnancy. The Mayo Clinic is conducting research on it.
“Most of the time, women survive, but there aren’t a lot of treatments,” she said.
Riemer also noted that new technology and new drugs are creating “an exciting time in cardiology.”
She cited diabetes drugs Ozempic and Mounjaro, which not only treat diabetes but result in weight loss that in turn reduces cardiac risk.
Much of Riemer’s work involves working with the diet and lifestyle of patients.
“Society has gotten itself into habits detrimental to health. High sugar diets, poor sleep, chronic stress” are all factors to remedy.
She noted that efforts have been made to help people with sleep apnea, which has cardiac complications if untreated. Also, research into food has shown the benefits of the Mediterranean diet because of its use of fewer processed fats and sugars. Moderation — whether it’s food choices, alcohol use or coffee consumption — all are important.
“The better you take care of yourself during life, the better you’ll age,” she said.
Kim Riemer, nurse practitioner with AdventHealth. Courtesy AdventHealth