[Congressional Record Volume 150, Number 32 (Friday, March 12, 2004)]
[Senate]
[Pages S2759-S2760]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                        WOMEN AND HEART DISEASE

  Mr. FRIST. Mr. President, I rise to talk about an issue that is very 
close to my heart, having spent most of my professional career fighting 
heart disease. I will start with a couple of facts people may or may 
not know, and then make several points in terms of the importance of 
prevention.
  Fact No. 1, as I travel around the country and talk, whether it is in 
the field of medicine or as a policymaker, is that more women will die 
of heart disease this year than men. I say that and it is surprising to 
many people because historically people thought because of the 
difference in gender and hormonal conditions women would be protected 
from heart disease. But, again, more women will die of heart disease 
than men. Indeed, each year 500,000 women--half a million people--die 
of heart disease in this country.
  Heart disease is a big spectrum, and heart attack is about one-half 
of those deaths, a heart attack where there is blockage of blood flow 
to a part of a heart. That means more than one-quarter of a million 
women in the United States each year are struck down by this one 
disease. In fact, heart disease is the No. 1 killer of women in this 
country.
  Heart disease is at the top of the list--it is No. 1--and kills more 
women than the next seven causes of death combined. So we have the top 
eight causes of death, with heart disease as the No. 1 diagnosis, and 
if we add up all the other seven, we still do not have as many as those 
who die of heart disease.
  As I speak right now, about 8 million women are living with some 
element of heart disease, a potentially fatal condition. In my home 
State of Tennessee, nearly 200,000 women suffer with heart disease 
which has proved that heart disease affects all age groups. Mr. 
President, 73,000 women in Tennessee are living with heart disease 
under the age of 64. So it is not just our elderly with heart disease.
  This is an area in medicine that can respond to education, to public 
information, but there are few people today who are aware of how 
widespread and how devastating heart disease is among women. We know it 
is among men, and we have seen the old images and the warning signs of 
a clenched fist, centralized pain as if an elephant is stepping on your 
chest, and if we look at the old pictures used in public education, 
health education, programs and posters, almost always it is a man with 
a clenched fist or grabbing both fists.
  That imagery is played over to the point that most people do not 
realize how serious this disease is in women. It is imperative that we 
get the word out, and I want to use this pulpit over the next 2 or 3 
minutes to do just that.
  I encourage people to learn what the causes of heart disease are, 
what the consequences of heart disease are, and what steps can be taken 
in order to lower the risk in terms of prevention because we know what 
the risk factors are. We know there are certain things that can be 
done, and if they are done, it minimizes the risk either of being 
debilitated by heart disease or dying of heart disease.
  The obvious things--again they need to be stressed because they are 
simple to do, but you have to do them--are improving one's diet, taking 
regular, consistent, and moderate exercise. One does not have to overdo 
it, but it is regular, consistent, moderate exercise.
  The addiction of smoking has so many people locked in its grasp. Some 
of our young people do start smoking, and then if they do start smoking 
they have to work very hard to break that addiction. I say that again 
as a heart surgeon.
  So many people I operate on--there are hundreds and hundreds of 
people I speak to and educate who are not in the Senate, but being in 
the operating room, opening up people's chests, taking veins out of the 
leg or from underneath the breast bone and hooking them on to the heart 
because of heart disease, that is strongly related to smoking. So if 
one stops smoking, it is less likely they will have that heart disease, 
and less likely that they will have the heart surgery.
  Preventive screening: There are preventive screening tests, things 
such as putting a blood pressure cup on the arm. In our recent Medicare 
bill that we passed 2 months ago, for the first time in Medicare we 
have a routine physical exam so things such as hypertension can be 
detected.
  It is amazing in Medicare, the great program that we have today--but 
one that needs to continue to be improved--that we did not have that 
basic entry level physical exam, where heart disease can be detected, 
until under President Bush's leadership we passed this recent Medicare 
bill.
  Sometimes heart disease strikes seemingly healthy women who may not 
have ever had symptoms, who have no history of either being sick or in 
poor health in some way, who have those risk factors. It attacks people 
who have not smoked as well.
  That is what happened to a Memphis mother of three, Kathy Kastan, who 
at the age of 42 suffered a heart attack. She tells her story this way:

       At 42 years old, I considered myself a healthy, optimistic 
     woman blessed with three healthy boys, a wonderful husband 
     and devoted friends. I have always been less than average 
     weight, a nonsmoker and have exercised my entire life. But 
     then I noticed that during exertion like biking or running or 
     swimming, that I would get strange symptoms like nausea, 
     turning pale, having shortness of breath. On occasion I would 
     get a tingling down my left arm and left sided shoulder pain. 
     But never once did I consider that I could have heart 
     problems. And then one day, in a blink of an eye my life 
     changed forever.

  As it turned out, Kathy had a condition known as vasospasm, or vessel 
spasm, which is exactly what it says, where the vessels go into spasm 
and they squeeze down; therefore, not as much blood can get through 
that vessel because of a contraction of coronary arteries. Coronary 
arteries are the vessels that feed the heart. The heart needs to get 
that blood, that nutrient, that oxygen because if there is obstruction 
of the blood flow going to the heart, the heart muscle does not work, 
and that is what we call a heart attack.

  Kathy went through five procedures where stints were inserted in 
these vessels. They are almost like a straw. If you can imagine, like a 
straw the vessel is squished down, and the stint is put in to keep the 
vessel open so it cannot squeeze down even when it goes into vasospasm.
  Then she underwent what is called a coronary artery bypass operation 
which does require opening the chest and taking a vein from the leg or 
an artery called internal mammary artery and hooking it on to the heart 
to bypass those vessels which contract down.

[[Page S2760]]

  For 8 months, Kathy says she simply could not believe what was 
happening to her. Remember, 42 years old, optimistic, healthy woman who 
had been struck by this disease. She was young, she was active at the 
time, and I quote:

       When I had chest pain, I even began to doubt myself and 
     thought that maybe I was going insane.

  Happily, Kathy is recovering and getting her life back to normal, and 
she credits her family, her close friends, her doctor, and the 
professionals at WomenHeart, which is a national organization devoted 
to educating, advocating, and supporting women with heart disease. It 
has been a tough road. There were days she could not even move from 
room to room in her own house without suffering these crushing, 
excruciating chest pains. She is getting the treatment she needs and 
again, in her words:

       I am back to being a mother who can take almost anything my 
     kids dish out.

  Well, Kathy is one of millions of sufferers and, like Kathy, before 
the heart attack many women do not even know they have a heart problem. 
They only find it out when it becomes severe.
  As majority leader of the Senate, and as a physician, as one who has 
spent his professional life studying that human heart and working in 
programs of prevention as well as treatment of heart disease, I joined 
with the President of the United States, President Bush, and First Lady 
Laura Bush, and other congressional leaders to launch what is called 
the Heart Truth Campaign. It is vital that we raise awareness so women 
get the treatment they need and that they take the proper precautions 
so they never have to have that later treatment.
  I encourage my fellow Senators to get the word out, to share 
information among themselves and among their own families, among their 
own communities and among their constituents back home to participate 
in educating the public about this very serious health issue.
  I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. DASCHLE. Mr. President, I ask unanimous consent the order for the 
quorum call be rescinded.
  The ACTING PRESIDING pro tempore. Without objection, it is so 
ordered.

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