Heart disease is the leading cause of death for women and men in Kentucky and the United States. February is American Heart Month, a reminder for us to pay attention to our cardiovascular health. We should all know our heart disease risks, blood pressure and cholesterol numbers, and learn to advoca te for ourselves. If I hadn’t had a primary care physician who paid attention to my family history of heart disease and prescribed medication therapy two decades ago, I might not be alive today. My mother had her first heart attack at 42 and her second at 46, followed immediately by quadruple bypass surgery. Forty-two is early for any onset of cardiac disease, but especially in women. Besides growing up in a household with smokers, she had no other risk factors for premature coronary artery disease. She died of heart failure in 2005 at the age of 58, too early for those of us who knew and loved her. Not only was her disease devastating for our family, but it was a wake-up call for me, even as a teenager, to become aware of my genetic risk factors. When I was diagnosed with high blood pressure and familial hypercholesterolemia (high cholesterol not affected by diet, weight, or medication) at 31, I was devastated, but not surprised. I have been on medications for those conditions ever since. Women have traditionally been underrepresented in heart-related research, and our symptoms can differ greatly from men’s, leading to underdiagnosis of disease and dismissal of symptoms. Though my mom felt the typical crushing chest pain normally associated with heart attacks, not all women do. Our symptoms can commonly manifest as fatigue or indigestion or an impending sense of doom. After shortness of breath and heart palpitations in my early 50s, and because of my mother, my doctor ordered a cardiac calcium scan, a coronary angiogram, and a simple blood test for a type of cholesterol not included in the typical HDL-LDL report. Lp(a) is highly predictive of negative cardiac outcomes independent of any other risk factors. All these tests indicated I had a moderate level of cardiac disease and a high risk of future cardiac events. I am only 54 years old. What would my heart have looked like had I not had a doctor who recommended aggressive medication therapy to mitigate my risk 20 years ago? Insurance did not cover the calcium scan or the angiogram because even with my family history of premature cardiac disease and decades-long history of high blood pressure and high cholesterol, I had not previously had a cardiac event. The company also would not pay for additional medication that is FDA-approved to reduce the risk of cardiac disease and is widely available, though expensive. In what world do we wait until someone has a heart attack before covering procedures that would accurately diagnose risk and current level of disease? The world of American private insurance. We simply must do better. People are literally dying because they don’t have information or out-of-pocket availability to fight for and pay for these life-saving diagnostic procedures. I urge you to do the following:  Know your risk. Learn the history of heart disease in your family; pay special attention to early onset cardiac disease.   Know your numbers: LDL and HDL cholesterol, Lp(a), and blood pressure. If they are high, ask about aggressive treatment.  If you don’t have one already, find a doctor who will listen to your concerns, order these diagnostic tests, and advocate for you. If your current doctor doesn’t take you seriously, find a new one.   Advocate for insurance companies to cover diagnostic procedures and medication therapies for the detection and prevention of early-onset coronary artery disease.  During a month in which we celebrate romantic love, let’s also put time and effort into celebrating our physical hearts. Know your risk, know your numbers, and advocate for yourself. It could save your life. The post A mother’s early heart attack. A daughter’s lessons shared. appeared first on The Lexington Times. ...read more read less