NIH Backs Leading Cardiologist's Work on Women's Heart Health

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2:16Bloomberg Audio Studios. Podcasts. Radio. News. You're listening to Bloomberg Business Week with Carol Masser and Tim Stenevek on Bloomberg Radio. The CDC, the Centers for Disease Control and Prevention, reminding us that the leading cause of death for women, Alexis, in the United States, heart disease. Yeah, it continues to be consistently. So over 60 million women, that is 44 percent in case you want to know, in the U.S. living with some form of heart disease. And it might surprise you that it can affect women at any age. She doesn't, not like an over 60, over 70 situation. We should note heart disease is also the leading cause of death of men in the U.S.

2:56All right. So it is a focus for everyone who is in medicine. And it brings us to our Bloomberg Business Week Women's Health segment. We focus on key issues and developing technologies impacting the present and future of women's health around the world. And we touch on kind of everybody in terms of health often. Joining us right now is Dr. Nupur Narula. She is director of the Women's Heart Program at Weill Cornell Medicine. And she joins us here in studio. Welcome, welcome. Nice to have you here. It's wonderful to be here. Thank you. I want to ask you, first of all, as Alexis and I just pointed out, that when it comes to heart disease, whether it's men or women, it's such a big problem here in the U.S., the number one killer and cause of death for both men and women.

3:33What is it? Our diet, lack of exercise, all of the above? What? Absolutely. And you have to think about other things as well. You know, you pointed out really nicely that young individuals can also be affected. And I think it goes to show that we really need to know a lot of things about our health. We really need to know our numbers. We need to know what our blood pressure is early. We need to know what our cholesterol is. We need to know what our blood sugar is. And certainly young people may have other genetic conditions, and it's important to know what those genetic conditions are. So you're focusing on something called an aorta aneurysm.

4:03I've heard of brain aneurysms. What is an aorta aneurysm? It's a great question. You know, the aorta very recently, just in 2024, was it's identified as its own organ, and very rightly and deservedly so. So it's the largest artery of our body. It attaches to the heart. It's actually shaped like a candy cane. And it takes blood, blood that's pumped from the heart, and it actually transfers it all the way to all the organs of our body, the head, the neck, the heart itself, the liver, the intestines, the spleen, the kidney, the leg. So it's critical for our sustenance. So much so that there are physicians such as myself, cardiologists, surgeons, really dedicate their lives in caring for individuals who have problems with the aorta.

4:42And one of those problems is an aneurysm. And an aneurysm is essentially a dilation or bulging of that aortic wall. And so it's a little bit distinct from brain aneurysm in terms of its location. But there are individuals with aortic aneurysms that can have brain aneurysms and vice versa. So you've got actually an NIH-funded study that you are doing. Tell us a little bit about that. Yeah, absolutely. And nice to hear that you are getting money and continue to get money from the NIH. Thank you. We actually recently got it. So I'm very, very grateful for such a milestone. You know, when individuals have aneurysms, once they really increase in size, dangerous complications can occur.

5:19And what do I mean by that? You know, you think of a balloon. As it gets bigger and bigger, a balloon can burst. The aorta, as it gets bigger and bigger, you can have a tear in the aorta. So now we have life-saving procedures, aortic surgery that can be pursued to prevent these complications that occur. I think it goes with the theme. We want to be proactive rather than reactive. And so what our grant looks at is it combines imaging, advanced imaging, and genetics to really figure out how individuals with aortic conditions do through time, especially those who've had that aortic surgery. So, I mean, I'm just hearing about this for the first time, aorta aneurysm.

5:54Are there symptoms? Is it the kind of situation where you don't know it until it happens? Because I know some of the brain aneurysms can happen in a snap. Yeah, absolutely. Yes, it is. I mean, you can have large aortic aneurysms and you may not know that you have one until something catastrophic occurs. I think there is a positive outlook on aspects of this. Now provider awareness is going up. Now we're doing imaging for unrelated reasons. People are getting scans for prevention-based readings. Now we're taking very intricate family histories. Yeah, you were going to say something. We're talking with Dr.

6:26Nupur Narula. She's director of the Women's Heart Program at Weill Cornell Medicine. It was so funny. I'm trying to think who did a story, whether it was the Times, whether it was us. But it was just this idea, if you go to, is it Korea? You can get scanned head to toe every year. What a brilliant idea. I don't know if our insurance companies would like that very much. And it's a lot less expensive, but it's such a great, preventative kind of way to go about it. And of like any kind of early problems that are out there. Why aren't we doing it? Is it just because it's so expensive here in the US?

6:57It's expensive. And so I think that there's certain - And why is it so expensive? Because if we were all getting it, the frequency, I don't know. It's a really good question. I think the more we scan, the more we find. You can find things that may not matter, but we'll go down roads of testing. Right. So I think that it goes to highlight a couple of things. Family histories, taking them from our family is free, right? Ask your family, have they had any sort of issues with the aorta? Has the aortic size been measured? Have they had any sort of prevention test? Did the aortic size come up in that test?

7:26Did anybody die suddenly in the family? If they did, was an autopsy done? You know, you can ask several questions to figure out what the cause of the passing was. So these are ways to screen. And then I always say, participate in research studies if you have the ability to do so. Because I think involvement in studies and women's involvement in studies is really, really critical. That's a really good point. And, you know, sometimes you go to the doctor. I've been asked, would you like to participate? I think the first instinct is, no, no, no, no, thank you. But it really can help science overall in general for years to come.

7:54Absolutely. And the more science we do, the more sex-specific difference. I did in college, but that's because I got paid. And some studies will still pay, actually, depending on what you do. But I think the participating in this allows us to also come up with sex-specific differences that have impact on behavior. Well, let's go another layer down because you specifically are focusing too on pregnant women. Why? So I think pregnancy is a very delicate time in our lives, right? There's several changes that happen. Your heart rate changes, it goes up. The blood pressure goes down initially, but in the later stages of pregnancy, your blood pressure rises, including after pregnancy.

8:31The cardiac output, the pump, the efficiency of our heart goes up because we're supplying blood to ourself, but also the placenta. And then you have all the hormonal changes that occur, estrogen, progesterone, and these can actually change the microstructure of the wall. So if you think of women who already have underlying aneurysms, and then you add in all of these changes, these women are in a more vulnerable state. So I think understanding what they have, their condition, instituting appropriate surveillance and thereby appropriate management allows us to take women through pregnancy safely.

9:02Your advice to maybe a pregnant woman hearing this or someone who has a pregnant person in their life and they want to be proactive. What's your advice to them? Know your numbers. Really know your numbers. Know all of your numbers. We very rightly talk about blood pressure, cholesterol, blood sugar. You should also know if you've had a scan, what is the aortic size? And also know your family history. Two big things to take away. We always need to be proactive rather than reactive in as many ways as we can. Is it more likely for a pregnant woman to have an aortic aneurysm? So it's not that the pregnancy will cause the aneurysm.

9:34It's that a woman may have an aneurysm. And during pregnancy, it is possible that that aneurysm may grow a little bit in size. Okay. I also, before we let you go, I was reading an article recently in the Times about the signs of a heart attack. And they're not always the outward, oh, I'm holding my chest, you know, shortness of breath. And there was one doctor who did some research in India who was saying, you know, if you look at blood pressure through the years, if your blood pressure seems to oscillate a lot, that could be a signal. Is that true? You know, I mean, I think, listen, I think anybody can have any sort of manifestation, right?

10:09So when you even think about blood pressure, in what environment are we measuring our blood pressure? Is it at home? Is it in the doctor's office? So certainly, you know, there are changes in blood pressure, changes in heart rate. And then there are symptoms, but there can be atypical symptoms, not the classic symptoms. that we see. And so I think if anything feels unusual, bring that to your provider. That's your time to really talk about it. You know your body the best. Like if something's going right, I have a feeling we're just sending a ton of people to the doctors and taking and getting their measurements.

10:37Doctor, thank you so much. Really appreciate it. Thanks for having me. Enjoyed it. Dr. Nupur Narula, she's director of the Women's Heart Program at Weill Cornell Medicine right here in studio.

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