Stacy Juchno, General Auditor, The PNC Financial Services Group

Featured Webcast Speakers:

Dr. Bhawanjit Brar, Ph.D., Co-Founder and Chief Executive Officer, Jaan Biotherapeutics

Dr. Indu Poornima, Director of Preventive Cardiology and Women's Heart Center at Allegheny Health Network

Lisa Iadicicco, Executive Director, Women in Bio




Ladies and gentlemen, I'd like to welcome you to our seventh webcast in PNC's 12th Annual Women in Business Week.  Today's webcast is titled, "The Heart of Women's Healthcare."

Before we get started, I'd like to mention that today's web seminar is being recorded, and you're currently in a listen-only mode.  It is my pleasure to introduce your moderator for today, and that is Stacy Juchno, General Auditor for PNC.  Stacy, you have the floor.

Stacy Juchno:

Good afternoon, or good morning, depending on where you're located and joining us today.  I'm Stacy Juchno, General Auditor for PNC, and today your moderator for this enlightening conversation on women's heart health.  This is a relevant conversation for PNC's 12th Annual Women in Business Week.  Cardiovascular disease is the leading cause of death for women in the United States.  In fact, about as many women die from heart failure and cardiovascular disease as men -- and yet, heart disease is commonly considered a male issue.

A heart attack is often referred to as "the widowmaker," and two-thirds of participants in clinical trials for heart interventions are men.  So, when it comes to gender equality, clearly there's a health gap as well as a financial gap.

And the reality is, the two are connected.  Financial stress is a risk factor for heart disease.  Throughout PNC's Women in Business Week, we've talked about accelerating women's financial equality and how this esteemed panel of experts are going to discuss accelerating women's heart health in part by closing that research gap.  We are excited to bring two organizations that PNC considers partners:  Women in Bio and the American Heart Association.

With me today are Dr. Bhawanjit Brar, CEO and Founder of Jaan Biotherapeutics, coming to us from the west coast; and Dr. Indu Poornima, Director of Preventive Cardio and Women's Heart Health Center of Allegheny Health Network in Pittsburgh, and board member of the American Heart Association; and Lisa Iadicicco, Executive Director of Women in Bio, an organization with chapters across the states that works to elevate women in life sciences.

Let's get started by talking about stress and the heart.  Some studies have shown the correlation between increase in wealth with lower heart risk, and a decrease in wealth with higher heart risk.  I have read that this issue is even more common and pronounced in Black women.

So, Dr. Poornima, can you help us understand what happens to the heart physiologically when women are stressed, about work, about money; and why is the stress so dangerous to the heart?

Dr. Indu Poornima:

Well, thank you, Stacy, and thank you to PNC for organizing this.  I am hoping that this session will touch the hearts of many women who can be proactive in their heart health.

So, to your question about stress and heart health, especially in women, we know that stress affects the body in different ways both in men and women.  It raises your stress hormones, which includes cortisol, other sympathetic hormones.  These hormones start constricting your blood vessels, and women's blood vessels are exceptionally sensitive to this increase in hormones.  And regardless of whether it's financial stress or emotional stress, we know that women tend to have both of those -- actually, more so than men -- because as you probably know, women take on many more roles and responsibilities in life than men do.  And as a result of which, the stress level happens to be higher, too.

So, these blood vessels start constricting over a period of time.  And when the constriction happens in the blood vessels of the heart, it actually leads to what is called as a heart attack.  And in addition to that, over a period of time when the blood vessels constrict and relax, it also leads to what is called as high blood pressure or hypertension.

So, women are exceptionally prone for this entity, and in fact, stress can also affect the women's heart in different ways other than constriction of blood vessels.  There's a specific entity called stress-induced cardiomyopathy, which usually presents -- typically occurs in women.  Eighty percent of stress-induced cardiomyopathy that occurs around the world, occurs in women.  And these are women that present with what is what is called as congestive heart failure, that happens rather acutely, within a few hours to within a day, where the heart function goes from completely normal to about 20% -- which, you know, can present -- where the women can present suddenly in the emergency room in what is called cardiogenic shock, where the heart is just not pumping enough blood.

And this entity is very unique to women, and it just tells you that the response of women due to the hormonal differences, perhaps, to stress can be very different from men.  As a result of which, I think women need to be able to manage their stress in order to improve their overall heart health.

Stacy Juchno:

So, Dr. Poornima, when I hear you say that -- you know women can have normal conditions and then in a matter of days they can go to 20%, why is -- if women suffer so much from this, even maybe more so than men, it sounds like, from listening to you -- why do we still associate heart disease with men?  I mean, is it -- is there something there that we should be doing to bring more awareness to this?

Dr. Indu Poornima:

Yes, absolutely.  I think, you know, the American Heart Association, obviously, has been sort of shining the light on this discrepancy and the gender inequality for many number of years, to the point that they started doing a survey among women to understand, what is the understanding of heart disease among women?  And even as close as 2019, when the last survey was done, less than 40% of women still recognize that heart disease is, in fact, the number one killer of women in the US.  So, one in three women will die from heart disease, or what is called cardiovascular disease.  And yet, less than 40% recognize that this is a problem.

So, while women over the age of 40 are quite aware that they need to have their annual mammograms, I don't think they think that heart disease is something that they can be affected with.  So, it has a lot to do with, you know, thought processes that have existed over the years, some of which also pertains to the scientific research that has focused on men, has systematically enrolled more men compared to women, and assume that the results that we've obtained from men, or the studies done in men, actually translates to women -- which we now know is definitely not the case.  Women, depending on where they are in their hormonal health, meaning if they're pre-menopausal, during pregnancy, post-menopausal, they respond very differently.  Men do not undergo those changes.  So, that, itself, we know needs to be looked at differently.

So, research has really lagged behind -- research enrollment in clinical trials, as well as translation of research that has been done in men to women, and with the assumption that it should be the same.  In fact, Bernadine Healey, who was the first woman president of the NIH, commented on this as what is called as a Yentl syndrome, is what she called it.  So, Yentl was a movie that Barbra Streisand was in, many, many years ago.  But she had to dress as a man to get the same job.  And so, women have to have the exact same symptoms as a man to be considered to have a heart attack, even by physicians or providers.  So, there's gaps on both sides.  Women have less recognition and awareness, and then providers don't wait for women to have the exact same manifestations as men to diagnose heart disease.

So, that's what has led to this sort of lag in understanding of women's heart health.  But as I started out, the American Heart Association started the Go Red for Women movement in the late 1990s in order to address this gap in awareness.  But as you know, there's still a lot more work to be done.  Because as I said, 2019 survey still only 40% of women thought that heart disease was something that they were affected by.

And again, talking about differences among races, both Hispanics and African-Americans -- in fact, the numbers were even lower.  It was close to 20% to 30%.

Stacy Juchno:

Well, you've got my attention.  I bet every woman on this call right now is listening, and saying, again, the annual mammograms, right?  But also, what do we need to do related to our heart health?  And I know your organization, the Women's Heart Center works closely with the American Heart Association.  What got you involved in this type of work?  You're very passionate when I hear you speak about it.  But what got you involved?

Dr. Indu Poornima:

Well, you know, I would say many life experiences including my mother, who was a heart disease patient and unfortunately passed away.  But you know, I saw it firsthand where as a mom, I think her interest and her focus, rather, was on taking care of the family -- as a result of which, you know, that proactive approach to taking care of your health in a timely fashion, making sure that you attended your doctor's appointments, took your medications on time.  All that sort of falls in the back burner for most women, and especially when you're trying to juggle multiple roles.  So, I would say that was my first inspiration.

And then I had some wonderful women mentors and men, male mentors, along the way who helped me recognize these differences in scientific research.  And when you read a scientific publication, when you look at the number of women that are enrolled in a clinical study, it systematically, like 10%, 20%.  So, we are translating data on 80% of men to women, and saying that these drugs should work exactly the same way in women when they don't know that that's true.

So, that gap, all of these life experiences, I think, is what got me interested.  And I think the goal of our Women's Heart Center, first of all, is to raise the awareness, and then to come up with strategies to help women along the different phases of their life, starting from the pre-menopausal woman who needs to be on oral contraceptives and may have heart disease risks, to women during pregnancy who have underlying cardiovascular disease, and then post-menopausal women who certainly the risk of cardiovascular disease does significantly increase after menopause.  So, that's really sort of the strategy and focus of the Women's Heart Center.

Stacy Juchno:

That's great.  And on behalf of the women on the call, thank you for your research; thank you for creating the greater awareness.

And I know, Dr. Brar, you're also working to change this dynamic as well, but from a little bit of a different angle, right?  Can you tell us about heart therapy and what you're doing at the Jaan Biotherapeutics, and how you got involved in this work?

Dr. Bhawanjit Brar:

Yes, thanks so much, Stacy.  So, my company, Jaan Biotherapeutics, is developing first-in-class treatments to regenerate new heart muscle within the heart, following a heart attack.  So the issue that occurs after the heart attack is that the heart muscle is deprived of blood and oxygen, and that results in permanent heart muscle cell death, and the heart muscle is replaced by scar tissue.  The heart becomes weaker, and heart failure develops.

And as Dr. Poornima said, a heart failure in ischemic heart disease is the single largest cause of death of both men and women in the United States.  And so, we're developing new treatments that can repair the heart after a heart attack, and prevent mortality and morbidity.

So, the technology that we're developing, we've licensed from the Salk Institute here in San Diego, and what we're doing is, reprogramming heart muscle cells to divide within the damaged organ and repair the heart with seminal processes that occur in babies' hearts.  A baby's heart muscle cells can regenerate, but in the adult, diseased heart, this cannot occur.  So, we're actually reverting some of the cells back to the fetal state to repair the adult diseased heart.

We are at the pre-IND stage, so we've just completed some pilot testing in female pigs with our treatment for the heart attack, following the pigs for a long period of time.  And we hope to develop our therapies to the clinic over the next year or so.

Stacy Juchno:

That's amazing.  And thank you for that research and the trials that are ongoing.  And I'm sure that funding and exposure and all this stuff has to move with the pace of some of that technology, so thank you for that work.

Now, Lisa, I know you're also working on this issue, but yet, from another perspective.  So, tell us how women in bio, you know, a little bit about that, and how you've come about creating the support system in life sciences just like Dr. Brar.

Lisa Iadicicco:

Yes.  Thanks so much, Stacy.  And I appreciate being a part of this conversation today, because it's really an important conversation.

 So, my name is Lisa Iadicicco, I'm the Executive Director for Women In Bio, which is an international nonprofit that is focused on inclusion and equity of all women in the Life Sciences and supporting industries.  We have a rich ecosystem with touchpoints in the life sciences, biosciences, biotech, that are very deep.

Our vision is really to connect the dots for all of the women and men, actually, who are members of our organization.  We have 14 chapters around North America, and when we were looking to partner with PNC, Beth Martello and I got together to talk about the PNC market champions that we could connect.  The organization offers educational programming, mentoring, robust network, advances careers and allyship and sponsorship for all women.

With Dr. Brar, she is one of our trailblazing entrepreneurs that WIB Entrepreneur Center have and continue to support through various programs like our Founders Forum, our Innovation Showcase, and virtual sessions to help women founders realize their goals and find funding, which is really critical.  I mean, we talked a little bit about the fact that gender bias has been ongoing in the healthcare industry as both Dr. Brar and Dr. Poornima said, because women were underrepresented in the trials -- the clinical trials.  And actually, the trivialization of women's complaints, you know, that's another thing that has really set us back.  But it includes the discrimination in awarding research grants and funding, and that's one thing that we are really trying to change the trajectory on.

Stacy Juchno:

That's great.  And I think the partnerships amongst all of the organizations together could really make that difference and change together.  So, the advancement of women in this area, right.  We need to see more female representation.  Do you think it's having an impact, based on what you've seen so far?

Lisa Iadicicco:

Definitely it is.  You know, we work with -- we start with middle schoolers and take them all the way through college, and first job/last job.  We have a -- our Executive Women in Bio programming, our Boardroom Ready program.  So if you start with us in eighth grade, you can stay all the way until you retire, and go and do some board service.  But we are finding that there's definitely improvement.  You know, young girls are staying in STEM longer now.  Normally we lose them in high school and then they're behind when they get to college.  We're working to really try to bridge that gap.  People who are in first jobs and researchers, trying to give them a pathway into industry because that happens a lot.  That's one thing about the life sciences/biosciences.  It never -- none of these amazing women seem to have had a linear track, right.  So it's been great to be able to support them where they are.

And Executive Women in Bio, you know, it used to be -- I don't -- probably 25 years ago, only 11% of women were on corporate boards.  And now, we're up to 16%, going to 20%, which is great, but we still have a ways to go there.  So, our programming supports women at all levels and at all sectors of life sciences.

Stacy Juchno:

And it's great to see women in innovation, right, and doing things and making that difference.

So, all week long we've talked about Project 257 and PNC's purpose to drive initiatives, to accelerate women's financial equity, and close that 257-year economic gender gap.  Closing the research on women's heart health could accelerate women's financial equity.  I'll maybe talk to you about -- or help you -- help me explain or understand this research gap, the size of the gap, why the gap.  Dr. Brar, you're an entrepreneur.  I'm guessing this gap is personal to you.  What challenges have you overcome as a woman entrepreneur in the life sciences space?

Dr. Bhawanjit Brar:

Gosh.  It's been really difficult.  So, we started the company in 2015.  Prior to that, I had 10 years of experience in developing heart failure therapeutics.  We've -- that had been developed to the clinic in pharmaceutical biotech companies.  And then before that, I was a research scientist in the cardiovascular area.

Originally when I started the company, having managed a Phase II heart failure trial here in the United States, I thought it would be relatively easy to get money since I had experience in the past, and you know, publications and grants and things like that.  But it was very difficult.  So, quite early on I decided that the easiest route for us to get financing would be through the National Institutes of Health Small Business Grants.

Now, those grants, these -- actually have to award 20% of the funds to minority -- minority groups, including women.  So that was how we obtained our seed funding, and that's how we'd primarily been funded for the last sort of six or seven years.  We've not been able to get any private investment, as such, knowing that VC investment is very scarce for solo women founders.  I think in 2020 only 2% of solo women founders' companies obtained VC money.  So it's very difficult.

So for us, the only way to get money and credibility for our science and what we were doing was through National Institutes of Health Small Business Grants.

Stacy Juchno:

And the access, as you mentioned there, the unequal access for women entrepreneurs to get that fund -- it really, ultimately the lack of capital to be able to do things just slows down the technology and bringing things to life.  And gosh, what your organization could do if they could have the capital in other organizations, women's organizations, women that are innovative.  We could really make a difference.

Dr. Bhawanjit Brar:

Yes.  I mean, it's unbelievable, really.  We could have got this to the clinic two years beforehand if we had received money or financing.  But you know, I'm thankful for the money that we have received, and the investment from the National Institutes of Health.

It is very, very difficult, and I think one of the issues is, is that getting this institutional VC funding, it's -- I'm not sure what the problem is.  You know, it's just -- you know, I can't figure it out.  We are working on, as we know, the single largest cause of death of both men and women in the United States.  Our technology is innovative.  We've got great experts within our team, like with cardiologists here in San Diego.  It has been tough, but we just have to keep moving forward and believe in what you're doing, and I'm very lucky to have surrounded myself with great advisors and cardiologists in San Diego that helped move the technology forward.  And you've just got to keep believing in what you're doing, and hopefully eventually, it'll work.  But keep moving forward.

Stacy Juchno:

And the struggle is real.  Thank you for sharing that with us so we have that perspective.  And I do believe that we will keep going, and that you and your colleagues will make a difference, and we will get there.

And I know, Dr. Poornima, you're an intra-preneur, someone who's working on the inside of the medical profession to advance women's heart health.  What challenges have you faced in the work that you're doing to sort of close that research gap for women?

Dr. Indu Poornima:

I guess I would look at it in two ways:  one is in terms of closing the clinical gap, which is as we talked about, raising the awareness, educating even my male colleagues about the need for recognizing unusual symptoms in women, and aren't waiting for the same symptoms as in men.  So that's on the clinical side.  On the research side, I think women need to have trust in their providers to enroll in clinical trials.  I think there's a lot of mistrust, especially among the minorities.  So that is something we need to really work on, to create that element of trust so that we can get equal enrollment in clinical trials and research.  That is one thing.

And the second is to make sure that clinical trials are -- include women in the leadership roles as well.  So, if you look at clinical trial leadership, at least in the US, right now less than 15% of the clinical trials have -- are led by women investigators.  So there is the need to increase that.  And with that will come I think more women participation as well in these trials.  So, those are the two ways I see women participation in research increasing.

And then of course, as I'm -- I have at least been a cardiologist now for 21 years, so trained a lot of residents and fellows along the way.  I certainly strongly encourage especially my women fellows to stay in academia, be it in education, research, etc.  So serving as a mentor and having women mentors always helps the next generation of physicians, I think, also take these roles.  So those are the different ways I would envision this field changing.

 And the more voices keep sort of pushing this agenda along, which is that research in women for cardiovascular disease needs to be looked at differently than research in men, as long as we keep pushing that message across, hopefully we will make some path forward.

Stacy Juchno:

I'm glad to hear you say mentorships, because those are the things that in every industry works, and it is much needed.

But I want to go back to a comment you made around the clinical trials and needing more women.  So for the women on the phone or listening to the call today are really -- what would you say to somebody that might know somebody that's interested?  Or maybe there's somebody on that's willing to be a part of it.  How would somebody go about getting involved?  Or is -- did they work through like the American Heart Association?  How does something like that happen?

Dr. Indu Poornima:

Yes.  So there are -- on the NIH website, there's a great patient resource page.  So if a particular woman has a clinical condition, and she's looking to see, okay, are there any clinical trials out there, it's called, and you just log onto that and all the clinical trials in a specific area are listed there.  You can easily search.

Of course, talking to your provider, you know, certainly not all providers are engaged in clinical research.  But talking to your provider and voicing your interest would be one thing.  [Inaudible] any health network, and especially within our cardiovascular institute, one of the first questions we ask of every new patient is, if a clinical trial comes along, would you be interested.  So, that is something we -- it is embedded in the electronic medical record such that if something comes along in the future, they are identified as a potential patient and we can reach across to them.

But those are the different ways that women can go out there and figure out if there are opportunities for them to get engaged.

Stacy Juchno:

That's great.  And the fact that there is an opportunity that they could help make a difference for the future.  That'd be wonderful.  At least I know through women -- Women in Bio play a role in addressing the health gender equality as well.  Talk a little bit about that, from your perspective.

Lisa Iadicicco:

I just wanted to mention about mentorship.  That has been -- that has been really a void for most women in companies in general.  There's been several studies that state that over 60% of women feel that they have not had formal mentorship -- mentoring at their companies, which is just -- is a very sad state of affairs.

Women in Bio, we do mentoring at all levels, which is really great, so there's all kinds of engagements, and women lifting women, which is really very fulfilling for us.  And we were talk -- when Dr. Poornima was talking about women in clinical trials, we have the same situation on entrepreneurs and funders.  Dr. Brar started talking about that -- that less than 3% of women-owned, or even women's health innovation, receives VC funding.  And it is because of the fact that most -- most VC funders and angel investors are male-run.  So, you know, getting more women to become angel investors would be a critical step.  And there has been lots of improvement in that area, because women understand women's issues.

Most men who run VCs, they find women's health innovation as a niche market.  Now, it is changing because we're standing on top of each other's shoulders to scream about it.  But there is still that perception.  And so, getting more women as funders and angel investors is really critical, and that is something that we help to promote within Women in Bio.

Stacy Juchno:

So, I loved it -- women lifting women, women supporting women, women funding women.  So, by providing financial support to organizations like AHA, Women in Bio, and investing in companies like Dr. Brar's, we can really work to close that health gender gap that's out there.

So let's just spend a little bit of time about creating some awareness among our largely-female audience about the warning signs of heart disease.  And so you know, I'm sure we've all read stuff, but whether it's the same for men, same for women, it's just as important, right.  But Dr. Poornima, what symptoms or signs should we look for in ourselves or for the women in our lives, that indicate they might have a heart issue?

Dr. Indu Poornima:

So, I think before we talk about symptoms, I think a couple things that -- you know, we talked about the mammogram being a way of screening women for breast cancer.  So, how do you screen somebody who's not having any symptoms?  Because a lot of these, what we call as risk factors for cardiovascular disease, are -- occur easily 10 to 15 years before you present with symptoms.  So you actually want to identify women before -- men and women -- before they have symptoms, and those are called risk factors, of which it's very simple.  The American Heart Association, if you Google Life Simple Seven, it tells you what to look for.  But among those are blood pressure, blood sugar, your cholesterol levels, whether you smoke, how much you exercise, what kind of diet you eat.  Those are essentially your risk factors for cardiovascular disease.

But another important one is family history, and especially knowing your family history of first degree relatives who may have had a cardiovascular event, which is essentially a heart attack, heart failure, or a stroke, especially if they occurred in a premature fashion, meaning that they occurred before the age of 60 or so.  That puts you at a -- gives you what is called a genetic risk, in addition to environmental risks, that puts you at risk for future cardiovascular disease.

So talking to your primary care physician about these seven risk factors, whether you have it, if you've not been tested for it, test for those things.  Very simple test.  A blood test is all you need for your cholesterol and your glucose, and the rest of it are essentially a blood pressure measurement and looking at your lifestyle factors.

So in terms of symptoms, so chest pain or chest pressure, especially in the center of the chest, is still the most common symptom in both men and women.  But women sense that a little bit differently.  They don't describe it ever as chest pain or chest pressure.  They describe it more as a tightness or as a burning feeling that may sometimes go into the neck or into the jaw.  It can radiate down into your arms.  It can radiate into your shoulders.  In fact, it's not uncommon -- and I have several women patients -- who have actually gone to their chiropractor first with what they described as neck or shoulder pain.  It started suddenly, but they chose to go to the chiropractor first.  And because those treatments did not work, then came to the emergency room, and they were diagnosed with a heart attack.

A lot of women tend to take their Tums and Pepcid and what-not, and think it's reflux symptoms when they feel that burning symptom in their chest.  And that does not mean that every time you get reflux symptoms you rush to the emergency room; that's not what I'm implying.  But it is important to recognize that you've never had reflux, and it did not happen soon after you ate -- all of a sudden, you were out walking, and you feel like there is a burning sensation in your chest.  Any symptom that occurs or is provoked by exertion, especially in the chest or upper body area, can be related to a heart attack, especially if you have risk factors for it.

So that's really what I would look for.  As you get older, women typically present with actually just shortness of breath.  So, every day you're climbing up those two flights of steps, but all of a sudden today you literally have to stop and [inaudible] before you can climb up the steps.  That could be a sign of a heart attack.  It could be the sign of congestive heart failure as well.

Fatigue, excess fatigue -- so again, you're able to run these two miles on the treadmill every day, but all of a sudden today, you're barely able to do that first 10 minutes and you're feeling really exhausted, and you're breaking out into a sweat.  Those could be signs of a heart attack.

So just listen to your body.  Any sort of unusual symptoms.  I think the first thing to get across is, let a healthcare provider make that diagnosis.  Do not diagnose yourself.  If it's an unusual symptom, and if your healthcare provider is not giving you the answers that you need, seek an alternative.  Because as I said, sometimes there's decreased recognition, even among providers, that heart attacks can present differently among women compared to men.

Stacy Juchno:

You said so much critical -- critical points there, and with the pandemic and everything, I think we've kind of stepped away from our own basic healthcare needs like annual physicals and just having our cholesterol checked; monitoring that high blood -- the blood pressure, making sure it's not getting too high.  Just those very basic things that we can be watching out for on a regular basis to take care of ourselves.

And then -- so I'll recap.  The Life Simple Seven from the American Heart Association, if you go to that page.  I think that's something that we'll all check out after we leave this session today, just to be able to look at those risk factors.  So, thank you for that.

You know, also, it comes down to some stress.  And besides alleviating the financial stress that's in everybody's life, what are some top things that women can do to prevent heart disease?  Or is it just sort of that -- those basic things of taking care of ourselves?

Dr. Indu Poornima:

Yeah.  I don't think anything unique, but finding time for yourself to I guess de-stress, easily said than done.  I understand that.  But I think that is important and critical, you know, just some deep breathing exercises.  Actually, there have been multiple studies done on this showing that it lowers your blood pressure by two to three points, and it actually lowers your heart rate, too.

So even when you are sitting at work, take five minutes to just do some deep breathing exercises.  Go out for a walk and combine that with deep breathing.  I mean, those are simple ways to incorporate both exercise, as well as some sort of stress management, in order to improve your cardiovascular health.

And in terms of exercise, again, I always tell patients, don't think you have to have a gym membership or you have to have some fancy equipment.  Just simple walking outside, and if it's cold outside, if you have steps at home, walk up and down the steps about five times.  Get your heart rate up.  That's all you need.  I mean, all that is advised is about 30 minutes, five times a week.  How are you going to break that down into 15 minute slots, or 45 minute slots, but a total of 150 minutes is what is advised from the American Heart Association, based on multiple studies.  That is the minimum you need to improve your cardiovascular health.

And I guess one other point I would like to mention is, in addition to knowing your family history, know about your pregnancy history.  So, again, the Heart Association is doing a great job in raising the awareness that pregnancy can be looked at as a stress test for women.  So if a woman goes through pregnancy and comes out without any sort of comorbidities during that time, and those comorbidities, that's basically high blood pressure during pregnancy, or most severe can be preeclampsia and gestational diabetes.  So if these do occur during pregnancy, that automatically increases your future cardiovascular risk, more so than a woman who did not have those conditions.

So have that history.  Remember to discuss that history with your primary care physician or with your gynecologist.  Ask them what else you can do to improve your cardiovascular health.

Stacy Juchno:

Thank you, Dr. Poornima.  That was very, just really good insights for everybody that's listening.

Before we move into the wrap-up, maybe I'll just sort of do a quick recap and then ask you all for some closing thoughts as to maybe your advice to the audience.  We talked a lot about various topics today -- the gender gap and the research, the things your organizations are doing, what the American Heart Association is doing; how we need to help fund more women-owned businesses in this space to help the technology move it forward; maybe even for those that are going through a condition, involve themselves in a clinical trial, right; our own health and awareness about early warning signs and risk factors before you actually have symptoms.

What would you all say is, you know, somebody leaving today, their call to action or the one thing that you want to make sure that they remember from this?  Maybe Dr. Poornima, we could talk to you since you're on the screen now before we move to the next one.

Dr. Indu Poornima:

I would say the biggest thing is, be aware that cardiovascular disease can affect anyone at any age, and be proactive about it, and then listen to your body.  I think that those are the two important things.  And as I said, you know, know your risk factors.  Those really determine what happens to you in the future.

Stacy Juchno: Dr. Brar?

Dr. Bhawanjit Brar:

Yes.  I would say just echoing what Dr. Poornima said, was really take time for yourself, like life is stressful.  You know, just take time for yourself, relax, look after yourself.  You look after yourself, you can look after your family, so put your health first.  And don't tuck it under the blanket, you know.  Just put that forward, and if you do look after yourself, be aware of your body.  I think that should -- you know, that should be a priority for women.

Stacy Juchno:

Thank you.  And Lisa?

Lisa Iadicicco:

Yes.  So I would suggest that everybody find your community.  You know, COVID has done so many strange things into everybody, it is manifested in different ways.  And I think finding a community of like-minded people is really important right now to be able to talk through all of these challenges that occur in life in general.  So finding your tribe and giving yourself a break, you know?  I think we all, especially women, we're always doing like, 12,000 things at one time.  You know, give yourself a hall pass to relax and de-stress.  I think that's really, really critical.

Stacy Juchno:

All these closing comments and suggestions are perfect, because you know, it's Spring.  We're moving into Summer time.  We all need to de-stress.  We need to relax.  And we need to focus on ourselves.  As women, it is so hard for us to take time for ourselves and make ourselves a priority, or our families, or jobs, kids, whatever -- whatever the topic of the day or the week is, and the focus is.  So please, for everybody that's listened today, hopefully this -- you've found this informative, enlightening.  There's things that you can take away and that you will do to help protect your heart health.

 I also want to -- again, thank you for joining today.  And don't forget, if you get a chance today, there's one more session around heart-healthy activities to close out the Women in Business Week.  That'll be up for you.  So please try to attend that session this afternoon.  And thank you all so much for attending.

Lisa Iadicicco:

Thank you, Stacy.

Dr. Bhawanjit Brar:

Thank you, Stacy.

Dr. Indu Poornima:

Thank you.