Valentyna Ivanova, MD: An Evolving Landscape in Women's Cardiovascular Care

Strategic Alliance Partnership | <b>Allegheny Health Network</b>

On Wear Red Day, Dr. Ivanova advocates for increased awareness and diversity in women's cardiovascular care.

A harrowing statistic shows that cardiovascular disease is expected to kill one women every minute, with 1 in 3 women in the United States expected to die of heart disease or stroke.

In a conversation with HCPLive, Valentyna Ivanova, MD, AGH McGinnis Cardiovascular Institute, Allegheny Health Network, discusses the necessary evolution of preventive cardiovascular care in women and the critical importance of representation and diversity in healthcare.

Check out the interview below to hear Dr. Ivanova's thoughts.

The full transcript has been edited for clarity.

Could you talk a little bit about yourself and your particular expertise and work in the field of women's heart health?

My name is Dr. Valentina Ivanova, and I am one of the staff cardiologists at Allegheny General Hospital in the Cardiovascular Institute in AHN. I joined the institution program in 2016. There is a women's health clinic that we were trying to establish for a long time and finally, it's running. We’re trying to expand to different areas in women’s health in cardiovascular disease, including through all different types of age. Since we do see only adults, we are not specializing in children's, So, in all the stages of women's health, we see them for different reasons in their lifetime.

I just wanted to briefly talk about the statistics that are still very terrifying when you think about it. Among all the causes of death, unfortunately, in 2022, the number one killer in women is from cardiovascular issues, and one in three deaths are due to cardiovascular disease. If you look at the bigger scale, we're losing one woman in the United States every minute to cardiovascular disease.

As we have the American Heart Association survey published in Circulation in 2020, that definitely shows us that we have too much work still to do. Between 2009 - 2019, the awareness of heart disease among women declined. We were really shocked to see those data. But, mainly in the age category between 25 - 34 years old, which I think this is the age group we really need to work on even more than before.

In the beginning of 2019, it was showing that 17% of women in that age category were able to recognize symptoms that would be related to heart disease, and it dropped all the way to 6% as of the end of the survey in 2019. So, there are multiple things that we need to work on. I think Women's Health Clinic is the one that can reach out and definitely help women of all ages to understand what to look for, how to live a healthier life, and how to move from there as the primary prevention for cardiovascular disease.

Based on those statistics and working to further raise awareness, how important are milestones like Wear Red Day and Heart Month for this process?

Very important, but we are mainly concentrating on the Heart Month, which is great that we have this Heart Month, and we can all talk about it. But, I don't think this talk should end when the month ends, and this is like day to day and year-to-year talk. We need to find some type of solutions based on the knowledge we gained from that survey and also on a day-to-day basis and studies that we have. How we can increase awareness, how we can increase health care, all across different ages and different populations, ethnicities, gender. We have a couple things that we're trying to implement and thinking how we can tackle this on our end, but it's really a long process and requires a lot of effort.

A couple of the solutions that were talked about especially in our clinic and I think across healthcare is that we should provide more culturally sensitive care, because that's very important. We see women of different ethnic groups. One of the things that everyone started to talk about, especially us, is how we can diversify our cardiologists too. First of all, I think women will be more open to come to the visit, at least with any issue if she's seeing women or women cardiologists, you know, that's one of the comforts. I think one of the things that we need to expand on.

Also it's important, because I've noticed that we need to be truly aware of different cultures, and the ethnicities of the person who comes to you as a patient. Women come from different backgrounds, they have different ethnicity, different culture, different way of cooking, different way of communicating, and knowing that part would be very important to get through the message to get through. I'm even thinking that diversifying providers not only to women, but also ethnic groups, will even increase that kind of communication on more channels and get the message through better.

Do you have any final thoughts on messaging clinicians can provide to women in terms of their cardiovascular health?

My main message to women is always listen to your body. Don’t say oh, I’ll do it tomorrow or there are very small symptoms here and there. If it starts happening, make sure you seek medical attention. At least, even if it’s a preventive visit and you think nothing of it, still ask. Even your primary care physician, if you don’t go right to the specialist.

And definitely live a healthy lifestyle. I always tell my patients that the best gift you can give yourself is to stop smoking, no matter what the age is, because it’s one of the killers of the vascular system and the inner lining. It leads to a lot of complications later on

If you know you have a family history of early disease, in women before age 55 and men before age 65, or if you know your parents or grandparents have already had a heart attack or stroke, be alert. Ask for primary prevention and talk with a cardiologist or with primary care physician about risks, if you are only 20.

There may be some predisposing factors, such as cholesterol issues, that needed to be attended to earlier than later. Exercise is a great opportunity to keep your heart healthy and weight in check. And it is always important to know your blood pressure and heart rate.

If you are young, you may not pay attention to it, but maybe it leads to those primary care visits to make sure you know where you stand. You can say something is abnormal now, even if there are no symptoms, so it is good for women to keep those things in check.