Call Your Mom: Study Links Positive Mental Health, Heart Health in Older Women

Pharmacy Times® interviewed Caroline Carney, MD, MSc, FAPM, CPHQ, chief medical officer of Magellan Health, a board-certified internist, and a board-certified psychiatrist, to discuss the correlation between heart health and mental health in women aged 65 years and older.

Alana Hippensteele: Mother’s Day is coming up, so joining me is Caroline Carney, the chief medical officer of Magellan Health, a board-certified internist, and a board-certified psychiatrist.

She’s joining me to discuss the correlation between heart health and mental health, especially in light of heart disease being the leading cause of death in the US and the number one killer of women aged 65 years and older, with approximately 1 woman dying every minute of this disease.

Why might heart health which is so connected to mental health specifically affect women aged 65 years and older in such high numbers?

Caroline Carney: I think there are a couple of things at play here. The first is that women are recognizing more and more that they too can get heart disease.

In the past, heart disease was often thought as something that men got from gaining weight, from smoking, or the kinds of behaviors that men often did more commonly than women.

Women are smoking more typically in certain populations in the country, the weight gain and issue with diabetes is affecting men and women, and because women tend overall to live longer, we'll see a proportion of heart disease disproportionately affect women at that age group.

I think the second thing is really in recognition of the symptoms. So, if someone came in before, if it was a man who said I'm coming in with chest pain, the literature shows that he would be more likely to get a workup for a heart condition, and the woman with the same episode of chest pain would be told ‘Oh, it's just stress,’ or ‘Oh, you're just anxious,’ and a lot of women have died because of misdiagnosis.

We understand the symptoms that men present with are different than the symptoms that women present with, and so I think an understanding, again, in the medical community of what heart disease looks like in women has also led to higher recognition, and therefore what looks like a disproportionate group of women getting heart disease.

Also, if women have better health behaviors overall, their heart disease likely won't develop until later in life, while men’s tend to be earlier in life. So, again, that disproportionate number will look like it affects women.

Alana Hippensteele: Right. How would you recommend women aged 65 years and older approach minimizing their risk for heart disease?

Caroline Carney: Look at the behaviors. Once again, look at what helps us be healthy: diet, exercise, sleep, reducing stress, and knowing our numbers—what's our blood pressure, what's our cholesterol, those important things at any age group remain important and can be changeable.

So, even weight loss of a few pounds can positively affect our blood sugars and positively affect our blood pressure. So, don't be hopeless in thinking that ‘Well, because I'm older now, it just doesn't matter.’ It absolutely matters at every age.

I really encourage women also, and men too, to find a buddy. Find someone to go do that fun activity with, to go for a daily walk with in the neighborhood, to get out and be social and support one another in developing the right kinds of behaviors.

Alana Hippensteele: Yeah, absolutely. Women have been disproportionately affected by the COVID-19 pandemic, specifically working mothers have needed to take time off from or even quit their jobs in order to assist with education at home and to oversee their children while schools are closed. What is the value of having pharmacists who are also mothers present in the pharmacy field today?

Caroline Carney: I think it's really important that we know and understand what our colleagues are going through, so that we can give them the right support.

The right support can be as simple as being a supervisor and understanding that a young working mom needs to have some flexibility in her schedule to take on all that she's doing. It might be providing the kind of behavioral health support through an employer that really will allow some services to that mom and that family, even childcare services.

It's important to also give that young working mom the message that it's okay to feel overwhelmed, it's okay to reach out for help, it's okay not to have to be strong and perfect all the time, but that finding that kind of social support is really critical.

I think just among women, being able to find other family groups to share some of the burden with—so, on Tuesday night, I'll cook your family dinner, and on Wednesday night, you'll do the same for mine, so that one night you can get a break.

Similarly, sharing the kids that same way—so, one day or evening, one family is taking care of the kids and having a playdate, if you will, and on another day of the week the other family is, so that mom can get the kind of rest and the time to retool.

Stress at a young age builds up over time, and so if we develop say hypertension at a younger age because of lack of sleep and because of the stressful lifestyle that one may be leading, that presence of that risk factor for a longer period of time will lead downstream to those kinds of conditions, like heart disease, that could have been prevented.

So, first step in all of this is to have the conversations like you're having today. Let's talk about it, let's get it out there, let's be open about what's happening. Don't keep it hidden.

Alana Hippensteele: Absolutely. Thank you so much for taking the time to speak with me today, Dr. Carney.

Caroline Carney: Thank you for talking about these important issues. I really appreciate the time with you all. Thank you.