Selected Podcast

Women and Heart Disease

Cardiovascular disease is the leading cause of death in the United States, according to the Centers for Disease Control and Prevention. For women, the signs and symptoms may be different than in men.

Manila Zaman, MD, joins the show to discuss women's heart disease symptoms, risk factors and lifestyle changes that can make a big difference in your risk for heart disease.
Women and Heart Disease
Featured Speaker:
Manila Zaman, MD
Dr. Manila Zaman is an assistant professor of medicine and a member of the medical staff at Temecula Valley Hospital.

She is also currently chief of cardiology at Loma Linda-Murrieta Medical Center.

She attended the Virginia Commonwealth University where she received her bachelor degree in chemistry. She received her medical degree at the Medical College of Virginia. Dr. Zaman completed her Internship in Internal Medicine at Penn State Residency. Dr. Zaman attended Albert Einstein Medical Center Philadelphia where she received her Cardiology and Interventional Fellowship.

Dr. Manila Zaman is board certified in Cardiovascular Disease and Interventional Cardiology.

Dr Zaman has over 22 years of experience and has performed the following procedures: echocardiography, coronary interventions, stress testing, stress echocardiography, holters and EKG’s.

Dr. Manila Zaman affiliates with many hospitals including Loma Linda University Medical Center, Loma Linda University Medical Center-Murrieta, Rancho Springs Medical Center, Inland Valley Medical Center and Temecula Valley Hospital.

Dr. Zaman is a member of the medical staff at Temecula Valley Hospital and has enjoyed teaching cardiology since 2004.

Melanie Cole: Our topic today is women and heart disease because the more a woman knows about heart disease, the better her chances of beating it. My guest is Dr. Manila Zaman. She's a cardiologist and a member of the medical staff at Temecula Valley Hospital. How prevalent is cardiovascular disease in women and why do you think in the past so much of the research, Framingham and all of these studies, have been done on men, do you see that changing? Are we starting to become more aware as women of our risk of heart disease?

Manila Zaman, MD: I would say the awareness of women of heart disease is the most important lesson that we have learned. In the past, it was thought that heart disease does not exist in young women. The research was done on males and currently, we are having more and more recent awareness. Heart disease is very prevalent and if you look at statistics, whether you combine the risk of cardiovascular disease with strokes, 1 in 3 women die from heart disease. The risk factor modification is quite important and the risk needs to be modified, taken care of, and the more women are aware of their risk factors, the more they will be able to take care of those risk factors.

Melanie: We’re going to talk about risk factors, but when we hear about signs and symptoms, people say signs and symptoms of a heart attack are different in men and in women, but what about the signs and symptoms of heart disease? Would that be different? We’re not talking necessarily about a heart attack, but progressive heart disease whether it’s blocked arteries, atherosclerosis or some of those things, even peripheral vascular disease. Are there some things that women should be aware of that they might feel or know about to get checked?

Dr. Zaman: Because women start having heart disease approximately a decade later, most women are older and they slow down. Sometimes they don’t have the typical chest pressure tightness or heaviness, which is more common in men. A woman may have severe fatigue or shortness of breath as they walk that’s non-exertion. They usually perceive that as ‘I'm getting older.’ They do not understand that these are signs and symptoms of heart disease, coronary artery disease or atherosclerosis in women. Severe fatigue, inability to do the daily activities they used to do, walking up the steps. They need to be aware that heart disease is very prevalent.

Melanie: What are the risk factors? Who’s at most risk for heart disease?

Dr. Zaman: The risk factors for heart disease, the most of the risk factors you have, the higher the risk would be. Age is an important risk factor. As we get older, heart disease becomes more prevalent, high blood pressure, diabetes, high cholesterol, smoking, sedentary lifestyle – those are the established risk factors.

Melanie: What about heredity and genetics? Is there a genetic component to heart disease?

Dr. Zaman: There is a genetic component to heart disease and a lot of times it is the hyperlipidemia that patients may have and that is passed onto the offspring. Not only that, if you have a parent that starts having heart disease, for men less than 40, for women less than 50 – in other words, if someone’s mother had a heart attack or coronary artery disease when they were younger than 40 or 50, that is a risk factor. If someone’s father had a heart attack at the age of 80, that would not be considered a risk factor for family history, but if they had a heart event before the age of 40, that would be considered a risk factor.

Melanie: As we’re looking at the risk factors and we’re looking at symptoms, things that change in your life, the ability to not do the things that you used to be able to do, shortness of breath and such things that you’ve discussed – what can we do to watch these things? If somebody is worried that they might have high blood pressure or diabetes and all these things all work together to contribute to heart disease, what do you want people to know about managing some of those risks, the controllable ones – blood pressure, diabetes, weight, nutrition, all these things?

Dr. Zaman: The way we categorize it is modifiable risk factors and also the risk factors that cannot be modified. In other words, when we get older, we cannot change our age, or if you're a male, you're at a higher risk than a female. Those are non-modifiable risk factors. The modifiable risk factors are diabetes, the cholesterol, the sedentary lifestyle, the high blood pressure – those can be fixed. Depending on the degree of those, there are things we can do, in other words, an increase in exercise and eating well; those are the things you can do at home. If you do have those risk factors, they need to see a physician and there's plenty of medication for all of those.

Melanie: People don’t always adhere to all of this. They don’t always take their blood pressure medication or get as much exercise. As a cardiologist, what do you want people to know about adhering to that healthy regimen and how much exercise is enough? How much is enough to help reduce our risk?

Dr. Zaman: 20 minutes at least three times a week is what is recommended. It doesn't have to be fast running, as long as you're walking fast, that is sufficient. In terms of non-adherence, I think the most important part is whenever I have patients in my office and I talk to them about 1 in 2 or 1 in 3, depending on how you calculate women that die from heart attack, and if you talk about those statistics, especially the risk of stroke, the more they know, the more they understand, the more adherent they will be.

Melanie: I think that’s true. The more the awareness is being, women are now more active and being proactive to be our own best health advocate, and that really seems to be the main message for women and heart disease or women in any of these conditions. What else would you like them to know? What about nutrition? Does that play a role in heart disease? What do you tell people?

Dr. Zaman: Absolutely. A low-fat diet is great. If you look on the website for the American Heart Association, they have very nice menus and also your recommended dailies, low-fat diets, lots of fibers. It's very beneficial and helpful.   

Melanie: Wrap it up and give us your best advice about women and heart disease, preventing heart disease in the first place, or raising more awareness for women and this terrible situation that is killing up to 1 in 3 women.

Dr. Zaman: I think the most important thing is awareness. There have been studies shown over and over again when people are aware that there are at risk they seek help, they take care of their risk factors, and my strongest advice to my patients is take care of yourself. Take control. If your diabetes is not well controlled, your blood pressure is not controlled, you need to ask why, you need to find the right physician that’s a good fit for you and take care of those risk factors. Be your own advocate. I usually tell my patients that nobody’s going to take care of you as well as you do. You are the most important person. Nobody will be as responsible as you are. You need to take control of your life. You need to control your heart; you have only one.

Melanie: Thank you so much for such important information. You're listening to TVH Health Chat with Temecula Valley Hospital. For more information, please visit That’s Physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.