Roberts, a clinical associate professor in the medical school, is director of the Women’s Cardiac Center at Providence’s Miriam Hospital. Her book, How to Keep from Breaking Your Heart: What Every Woman Needs to Know About Cardiovascular Disease, was recently published.

BAM Why did you write this book?
Roberts Cardiovascular disease is the number-one killer of women, yet I found there was very little out there directed at women.

BAM What are the risk factors for women?
Roberts They’re the same as risk factors for men, but they’re weighted differently. Smoking is deadlier for women.

BAM Does taking estrogen help?
Roberts No. Hormone replacement therapies actually increase women’s risks of heart attack, stroke, breast cancer, and dementia.

BAM Is there a gender bias in diagnosing heart disease?
Roberts Yes. Most of it isn’t malicious. In the past we were taught that the symptoms of heart attack are crushing chest pains, sweating, shortness of breath, and a feeling of impending doom. Nobody knew that women had different symptoms. It was only when we really started paying attention to women that it became obvious that women are more likely to have silent heart attacks—a heart attack with no pain at all.

BAM Do they have any symptoms?
Roberts They may just have shortness of breath, or if they have pain it might be in the jaw, in the back, or high in the stomach. They may just have nausea and vomiting, or just feel extraordinarily fatigued. The fact that many doctors today are unaware of these symptoms may contribute to the fact that a woman is twice as likely as a man to die of heart attack.

—Interview by Maria Di Mento ’03