Health + Medicine
Closing the Women’s Heart Health Gap
Whenever cardiologists and friends Drs. Jennifer Mieres and Stacey Rosen get together on the weekends, they are on the move.
That’s not an unusual state for Dr. Rosen, senior vice president of the Katz Institute for Women’s Health at Northwell Health in New York, and Dr. Mieres, senior vice president at Northwell’s Center for Equity of Care and the health system’s chief diversity and inclusion officer. During the week their schedules are overfilled, and they often have time only for a quick lunchtime check-in on Zoom.
On Saturdays or Sundays, however, they meet in Central Park in Manhattan for long midday walks. Striding through the park’s scenic vistas, they share updates on their families and children, talk about their work and confer on joint projects that address their shared passion: raising awareness of women’s heart health.
As important as the discussions often are, they also walk together to encourage each other’s heart-smart habits. “Our friendship is both professional and personal, and you want to keep your friends healthy,” said Dr. Rosen.
Drs. Mieres and Rosen have known each other for 30 years. Award-winning female leaders and advocates for women’s health in the male-dominated cardiology field, the two come from different backgrounds. Dr. Mieres, 64, was born in Trinidad and, encouraged by her parents to be “a citizen of the world,” she said, moved to the United States to attend college.
Dr. Rosen, 62, the daughter of educators who devoted themselves to underserved communities, grew up in New York City. They often joke about their different strengths. “Jen is the inspiring visionary girl, and I am the ‘make the trains run on time’ kind of person,” said Dr. Rosen.
Yet they have much in common. They were only a year apart at Boston University School of Medicine, although their paths didn’t cross there, and both are married to doctors.
Each has been honored with the American Heart Association (AHA)’s Physician of the Year award—Dr. Rosen in 2021 and Dr. Mieres in 2022. They have taken on roles at national nonprofits: Dr. Mieres is the spokeswoman for the Go Red for Women campaign of the AHA and Dr. Rosen is on the scientific advisory council of WomenHeart, which advocates for women with heart disease.
And both physicians are Jewish. Their families celebrate holidays together—gathering for Rosh Hashanah meals, Passover seders and Thanksgiving—as well as life-cycle events such as b’nei mitzvot and children’s weddings. Both have spoken about women’s heart health at Hadassah events; Dr. Rosen is a life member of Hadassah.
Their shared focus and partnership are essential to their work. As Dr. Rosen is fond of saying, “The road to a heart-healthy life shouldn’t be walked alone.” That mantra has defined their many collaborations, including gender-based cardiac research, documentaries on women’s heart health and two books—Heart Smart for Women: Six S.T.E.P.S in Six Weeks to Heart-Healthy Living and its follow-up, Heart Smarter for Women: Six Weeks to a Healthier Heart, both co-authored with attorney Lori Russo, a consultant on women’s health. Together, they are spreading awareness about heart disease among women, which is the No. 1 cause of death in women in the United States, according to the Centers for Disease Control and Prevention.
“Cardiology for me was personal, and medicine was personal, because I lost my grandfather when I was 7 because of a heart attack,” said Dr. Mieres, who lives in Manhattan. “I was on a mission to become a doctor,” with a focus on cardiology.
For her part, Dr. Rosen, who lives on Long Island, had been captivated by studies of the heart when she was in medical school and saw a need, in the 1980s, for more female cardiologists to bring a missing perspective to the field. Today, only about 15 percent of practicing cardiologists are women, according to a report from the Association of American Medical Colleges. Back then, the percentage was even lower.
The two met in 1994, when Dr. Rosen joined the staff at North Shore University Hospital in Manhasset, N.Y. (now part of Northwell Health). Dr. Mieres had been working there since the previous year, the first female cardiologist at the hospital.
There was an immediate connection, said Dr. Mieres, a warmth and ease that fueled a deep friendship and a shared drive to further medical equity for women. “It was quickly clear that we were in this field for very similar reasons,” Dr. Rosen said.
Their public advocacy is more crucial than ever. Studies on sex differences in heart disease have shown that the gap in awareness about women’s heart health (and women’s health in general) has not only persisted, it has also grown. According to a national survey conducted in 2019 by the AHA, awareness that heart disease is the leading cause of death for women has declined in the past decade, despite that awareness being on the rise before 2009. Many women, particularly those under 65, do not know that heart disease is more deadly than all cancers combined.
To reverse that trend, Drs. Mieres and Rosen co-produced the award-winning 2020 documentary Ms. Diagnosed, highlighting inequities in care due to male-centric medicine. Weaving patient stories with commentary from experts, the film urges women and health care providers to advocate for women’s heart health.
Ms. Diagnosed was their second documentary. Their first, A Woman’s Heart, from 2001, follows the stories of three women whose diagnoses of heart disease were delayed when their symptoms went unrecognized. Dr. Mieres, who has spoken on the Today show and other national television outlets on the topic, also has produced two other health-related documentaries and co-authored Reigniting Human Connection, a book on health equity.
Heart Smarter, the pair’s most recent collaboration, maps out a common-sense path to better heart habits: healthy eating, exercise, controlling stress and adequate sleep. As the book notes, 80 percent of heart disease can be prevented through lifestyle changes.
The book also serves as a primer on signs of heart disease in women, which are often different from the classic signs that occur in men. “Heart disease warning signs can be subtle,” the doctors write. “Women often ignore what they think are minor aches and pains, but you need to know that if something doesn’t feel quite right, it probably isn’t.”
They detail risk factors significant for women: previous pregnancy complications such as preeclampsia and gestational diabetes; autoimmune disorders like rheumatoid arthritis and lupus; and the rise in risk for breast cancer survivors who received radiation treatment.
Heart Smarter also explores general heart issues associated with age, family history and ethnicity. For example, Black and Latina women and those of South Asian descent are more likely than white women to have high blood pressure and metabolic conditions such as diabetes, which increase heart disease risk. While there are no specific risk factors associated with Jews from Eastern Europe, Dr. Rosen said, Heart Smarter advocates for a Mediterranean diet (fish and other lean proteins, nuts, olive oil, fresh fruits and vegetables) for all women.
“Despite the perception of heart disease as a ‘man’s disease,’ ” the doctors write, “women and men are at equal risk of developing heart disease and suffering a heart attack.”
In their books, Drs. Rosen and Mieres credit the pioneering women who laid the groundwork for greater equity in health care. Among them was Dr. Nanette K. Wenger, a cardiologist and past president of Hadassah Atlanta who was among the first back in the early 1990s to call for more attention to the treatment and prevention of heart disease in women.
They also note mentors such as Dr. Judith Hochman, professor and senior associate dean for clinical sciences at New York University’s Grossman School of Medicine, who empowered Dr. Mieres during her specialization in cardiology at NYU.
“Their work is incredibly important. Women are still underdiagnosed and undertreated,” Dr. Hochman said.
Now both of them are gaining recognition for their roles in mentoring a new generation of female doctors as professors at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell on Long Island. Dr. Mieres, currently dedicating her efforts to advocacy rather than individual patient care, became the first female president of the American Society of Nuclear Cardiology in 2009 and received the Women in Cardiology mentoring award from the American College of Cardiology in 2014. Dr. Rosen, who is still a practicing cardiologist, received the AHA’s Women in Cardiology Mentoring Award in 2018, and WomenHeart honored her with the Wenger Award for Excellence in Medical Advocacy in 2023.
In their personal lives, both try to live up to the principles they set out in their books and films. In addition to their weekend get-togethers, Dr. Mieres puts aside an hour to walk every day, tracking her steps with her Apple Watch. She also listens to the meditation app “Ten Percent Happier” each morning to start the day on a positive note. Dr. Rosen blocks out time for two 90-minute yoga sessions each week and makes it a priority to have a consistent bedtime that allows at least seven hours of sleep every night. But they readily acknowledge that the pressures of a career and family life make it challenging to stick to any health plan. “Give yourself some grace,” said Dr. Rosen, emphasizing the importance of small lifestyle changes.
Even with all the accolades, the two are finding new ways to spread their message. They are currently working on short companion films to their books that could be combined with in-person programs.
“We have to reignite the passion for this,” Dr. Mieres said, referencing the decline in knowledge about women’s heart health. “It has to be a concerted effort.”
Michele Cohen Marill is an Atlanta-based health journalist.
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