Q&A: Dr. Sandy Charles on heart health and outreach

COURTESY NOVANT HEALTH

Dr. Sandy Charles M.D. is a cardiologist and director of the Women's Heart & Vascular Center at Novant Health.

During American Heart Health Month, The Post interviewed Dr. Sandy Charles, a cardiologist and director of the Women’s Heart & Vascular Center at Novant Health. In the United States, only 12% of all cardiologists are women.

Charles shared her experience of working in a male-dominated field and how she became the first African American woman to be hired to join a 40-physician team in the department of cardiology at Novant Health Presbyterian Medical Center in 2015. Charles, who also serves on the American Heart Association’s Board of Directors in Charlotte, discussed the importance of heart health and why Black women remain most likely to develop cardiovascular disease in the U.S.

The AHA’s Go Red for Women initiative aims to raise awareness for women’s heart heath and improve the lives of women globally.
Responses were edited for length and brevity.

Where did your passion for cardiology first start?
My parents and grandparents, they come from Haiti. They came to the United States and moved to New York. So I was born in Brooklyn, New York. And as a young child, I used to go to doctor's appointments with my grandmother. She had high blood pressure and diabetes at a young age, but she would always complain about her doctors. She would complain that they didn't listen to her that they didn't take the time to understand her.

She complained that she didn't really feel seen and she just felt like he never took the time to explain things in a way that she could understand. Because of that, she developed trust issues. It was really hard for her to adhere to all their recommendations. She always sought out more natural remedies and therapies and because of that, I quickly watched her decline with complication after complication of cardiovascular disease. She started having strokes at a really young age, and I've watched her go from being vibrant to just slowly but surely losing all function in her body.

She then developed kidney problems [placed on] dialysis and she died at a much younger age than she should have (Charles’ grandmother died in her early 70s).  When I realized that about 80% of cardiovascular disease can be prevented with healthy lifestyle changes, that really sparked a flame in me. I realized at that point, that not only do I want to be a doctor, I wanted to become a cardiologist, because there's so much that you can do to change the trajectory of disease for people. I really wanted to be the type of doctor that I wished my grandmother had. I wanted to connect with patients to empower patients to educate them, and really help them partner with them so that they could take the best care of themselves possible.

You currently serve as director of the Woman’s Heart and Vascular Center at Novant Health. Can you explain more about your role?

I noticed that women patients definitely gravitated towards me. A lot of times they were coming for a second and third opinion. I found that patients who were told that they just have anxiety or that their asthma was bad. I was able to find out that in reality, they actually had really bad coronary disease. Some of them needed open heart bypass surgery and were told that everything was fine, but it's because of taking the extra time to really listen and think about the risk factors and understanding that nobody knows their body like you know your body.

When a patient says “something just doesn’t feel quite right. I feel a little short of breath like when I go upstairs” – I’m not quick to disregard that. Even if preliminary tests are normal, I’ll still go on to do more testing to really make sure that everything is okay. I really found after a couple of years that there was a niche for a focus on women’s heart health, between helping to manage our complications in pregnancy, or menopausal risk factor, or risk factors of hormone therapy and women with menopause. I decided that I wanted to take that on as a focus.

I’m thankful to Novant for helping me bring that vision to life. In 2020, in the throes of the pandemic, we opened our office and it's been extraordinarily successful. I help prevent and control risk factors of heart disease, so I help treat high blood pressure, high cholesterol, and I spent a lot of time talking about nutrition and ways to prevent needing medicine. I encourage patients to get their blood sugars under control.

For people who have had heart disease, heart attacks, heart failure, atrial fibrillation, or vascular abnormalities, I help treat those problems. I also help with tests, so I do special ultrasounds called cardiogram. I perform and interpret stress tests and I also go to the hospital and take call and help with emergency cases on weekends.

What do you love most about your career?

What I love most about my career is really the ability to change lives and to change habits and to save lives. When I started working, my position was everything I could imagine. But I really had like an insatiable thirst and just a strong desire for more outreach, community outreach.

African Americans have increased risk of heart disease. African American women are particularly at risk. Sixty percent of African American women aged 20 and older have some form of cardiovascular disease, which is just alarming and unacceptable. So really prioritizing, improving those numbers. Raising awareness is something that I like to do and then also mentorship. Letting other kids out there in the future generation of doctors know that they can do it and to know to not let anyone stop them.

At a young age, I knew I wanted to be a doctor, but guess what, I never seen a doctor that looked like me. I had no doctors in my family. And the first time I met a black woman doctor, I was 21 years old, so it’s hard to be something that you don’t see. Even through social media, providing that visual imagery I know has definitely helped a lot of African American youth feel like they can do it too, which is really important.

What challenges have you faced as a woman of color working in a male dominated field?

One of the big challenges I would say is balancing as an African American woman. I'm a cardiologist. There are a lot of needs that you want to fulfill the needs of the patients that I see in the office and the hospital. The needs of a community that I want to do, my local community, the needs of the greater community, then also having needs for my family and myself.

One of the things I also talked about is the Superwoman phenomenon. A lot of times, women especially Black women, have a lot on our plate. We're working inside the home – cooking and keeping things in order with our families. Working outside of the home to pay bills, taking care of grandparents, and just dealing with the stresses that come with being an American in this day and age. Realizing that you need, and we all need to make time for ourselves as much as we give and give. If we're not taking the time to sleep seven hours a night to rejuvenate ourselves that can put ourselves at risk for heart disease---If we're not taking the time to find 30 minutes to exercise, we can put ourselves at risk. 

So the biggest challenge is really finding the time to carve, to give and to also, pour into yourself into your own health. Another thing I would say is not listening to all the naysayers. Growing up, I got to be valedictorian of my high school class and I remember people questioning like, oh, you know, you got into Princeton [University], but do you want to go there? It’s really challenging. Can you do well there? Not letting that impact your ability to succeed When I got into Princeton, I knew I wanted to be pre-med and major in molecular biology, but there are people saying like, “that’s the hardest major – are you sure you want to do that? Are you sure you’re ready?” Not letting those voices get the best of you.

All along the way, I had to really fight the naysayers even wanting to go into cardiology. A lot of people were like, don't do it. It's not a good field for women and having a family. I'm glad I was able to have the mental fortitude to not let the negative comments dissuade me from doing something that I really wanted to do.

Black women are at an increased risk of developing heart disease than Black men. Why is this?

Unfortunately, the risk factors for cardiovascular disease are more prevalent in Black women. There's a higher risk of high blood pressure and there's, some studies suggest that this may be genetic. But this also could be just from consuming high sodium foods. Women also have a higher rate of diabetes and higher rates of obesity, and lack of exercise.

Unfortunately, studies are finding more and more that the effects of stress are real, the effects of stress, and racism really have a huge implication for overall health and cardiovascular health.  That is also something that more awareness needs to be raised about.

With heart disease, is it just sodium intake or does sugar also play a factor?

Salt and sodium can affect whether you develop high blood pressure, but diabetes significantly increases the risk of heart attack and stroke. Knowing that we should get routine screenings, even though you're feeling well, and you look well, everything may not be well.

Knowing that you have to make the time to get screened to see if you have diabetes, and get that taken care of and making the necessary changes. I tell people, you should always know your numbers. So just like we know our dress size and our shoe size, we should know what our recent blood pressures were. Things like blood pressure, blood sugar, cholesterol, they typically don't cause any symptoms, but can really increase the risk of heart disease, stroke and death.

Normal blood pressure should be less than 120/80, blood sugar is checked with something called an A1C and that should be less than 5.6. Our cholesterol level, our bad cholesterol should be less than 100.

According to the Heart Association's website, women have different side effects for heart attacks and strokes. Can you explain more about that?

For many decades, heart disease was thought to be a man’s disease, and I later found out that it’s because men were commonly present with severe chest pain. Though women do also have chest pain frequently when they’re having heart attacks, they also can have a lot more subtle symptoms, so things like pain that’s not in the chest, pain in the neck, or the arm or the back [that can] be a sign of a heart attack.

Sometimes there’s no pain at all and sometimes it’s just feeling like your breathing is heavier than it should be or having shortness of breath. That could be a sign that something’s really wrong with your heart and sometimes it could just be something like severe indigestion or severe fatigue. Once I had a patient who thought she was just suffering from the flu, because she was so tired, she had chills, she went to bed and when she finally went to the hospital over 24 hours later. She was having a massive heart attack that started the day before.

So really raising awareness to women in particular that if anything, just feels really wrong, not wasting time and going to get it medically evaluated, you would much rather be wrong than to miss something that could have been treated early.


Can you explain more about Go Red for Women through the American Heart Association?

We all know about breast cancer, which is exceedingly important. But heart disease kills exponentially more women. However, a large percent of women have no idea that they’re even at risk.

Go Red For Women has been a wonderful campaign that has really raised a lot of awareness for heart disease, and though we’ve come a long way, we still have a long way to go. One of the things that I also really love about the American Heart Association and Go Red For Women is that they’re paying particular attention to the need to diversify the racial demographics of doctors and are really encouraging STEM education in young minority girls. That is a wonderful way to kind of help the pipeline for the future and improve care and outcomes for African Americans.

Aaliyah Bowden, who reports on health at The Post, is a Report For America corps member.

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