Dr. Marianne Legato, a cardiologist whos consistently named as one of the Best Doctors in New York, is a Professor of Clinical Medicine at Columbia University College of Physicians & Surgeons, and Adjunct Professor of Medicine at Johns Hopkins Medical School. She is also the founder and director of the Institute of Gender-Specific Medicine at Columbia University. Legato is truly the mother of this increasingly respected medical discipline. Recently, ThirdAge talked to her about heart health, gender-specific medicine and the wellness advice she gives to her many patients.
ThirdAge: Do you think women today are aware that heart disease is such a serious health threat and that more women die of heart disease than any other cause?
Dr. Legato: I think women are much more aware and so are their physicians. Nowadays I see women who are appropriately evaluated for heart disease, even in their 40s.
ThirdAge: What is the best thing a woman can do to stay heart healthy?
Dr.Legato: I would say reduce stress. I just had a symposium at Columbia on stress and the heart, and women are particularly vulnerable because they are expected to be perfect at home, professional at child rearing, professional at running a household and perfect at work. That gives them plenty of stress. Of course, the other things are smokingabout the worst thing you can do. Obesity is a problem and not exercising enough. Exercise is a stress-buster.
ThirdAge: Do you exercise?Dr. Legato: I dont go to the gym. I walk everywhere but like a lot of women, I dont prioritize enough about what is really important for my health. But one thing Ive tried to do is cultivate friendships more, make time to socialize, give dinner parties, have friends to my home. I find as I get older, cultivating friendships is a much more important part of my life. ThirdAge: You are an expert on gender- specific medicine-- really the leader in the field. But what does gender-specific medicine mean exactly?Dr. Legato: Gender-specific medicine is the study of the differences of every aspect of normal function in men and women, and the ways in which a greater understanding of these differences can revolutionize the investigation and the treatment of illness. The purpose of the Institute I founded is to educate physicians and the public about this important new field and to fund scientific research that takes these differences into account. I believe a recognition of gender differences is crucial to improving the health of womenand of men as well. Iwas an early advisor tothe Office of Research in Womens Health at the National Institutes of Health and have written books on womens health (Eves Rib, The Female Heart), but I have also been concerned and written about mens health issues as well. (Why Men Die First).
ThirdAge: We all appreciate the obvious difference between men and women, but are there, shall we say, hidden differences?Dr. Legato: It is not just differences in the way they look or their sex organs. Their brains are different, too. I wrote a book about that called Why Men Never Remember and Women Never Forget. In fact, what we are learning is that men and women are different biologically in every system of their body, in every cell and molecule. This certainly impacts how they respond to medicines. It is important in analyzing the results of medical tests and in deciding on the best course of treatment. Before there was a focus on gender-specific medicine this was never truly taken into account. But now, Im pleased to say, there is a new worldwide interest in this field. Im now asked to speak very often all over the world on this subject. For example, I am going to Vienna in a couple of months to keynote a major conference. And there is alsoand this is very exciting-- an emerging interest in the combination of genomic medicine, the study of genes which, of course, is such an important part of medical research today, and gender-specific medicine.ThirdAge: How can a woman make sure she is being treated in a gender-specific way?Dr. Legato: Well, as I said, it is improving. Certainly in the field of cardiology womens heart problems are better diagnosed and better understood. But, remember, I am not talking only about women.
ThirdAge: What do you think are the greatest vulnerabilities men and women have?Dr. Legato: For women, it is what I call the good- girl syndrome, always having to be the good girl, caring for others, never focusing enough on themselves. For men, it is the fact they always have to be strong, be the protector, never admitting any imperfections. I tell my patients to look at how they spend their days, how many hours do they spend enjoying themselves. I tell them they deserve to spend their time doing what they really want to do. But I also understand that isnt easy to learn how to do this when you have spent your life being a good girl, or being a strong, seemingly invulnerable male ThirdAge: What is the biggest medical breakthrough you envision for the future?Dr. Legato: I think by 2020 the average lifespan could be dramatically increased.ThirdAge: Thats not very long into the future. It is only twelve years.Dr. Legato: Yes, and it will happen when we begin to understand, on an individual basis, a persons vulnerabilities and strengths and take them both into account when we treat that person.About the author: Myrna Blyth, Editor-in Chief of ThirdAge, was the former editor-in-chief of Ladies Home Journal and founder of More Magazine. She is the author of the New York Times bestseller Spin Sisters. Tell us: Are you more aware of heart-health issues than you used to be? Do you think you get the best possible treatment from your physician? Our new commenting system makes it easier than ever to tell us what you think.
