Heart disease and stroke are the number one killers of women in the United States, causing more deaths than all cancers combined. Legendary director, singer, actress and producer Barbra Streisand is on a mission to change that fact. She co-founded the Women’s Heart Alliance to prevent women from needlessly facing and dying from heart disease and stroke. Women’s Heart Alliance scientific advisor, Noel Bairey Merz, M.D., director, Barbra Streisand Women’s Heart Center in the Smidt Heart Institute at Cedars-Sinai, spoke to her about her deep commitment to this cause.

The story of how you got interested in heart disease is unique. Would you mind sharing it?

Certainly! When I made my movie “Yentl,” in which a young woman gets an education by pretending to be a man, I had no idea the project would, in a roundabout way, lead me to advocate for women’s heart health. But years later, I read about “Yentl syndrome,” a phrase coined to describe the finding that women with heart attacks get substandard care compared to men. That inequity persists to this day.

Why don’t more women know about their risk?

 In a Women’s Heart Alliance survey, we found that a lot of women are embarrassed about having heart disease. Others aren’t aware that they have it. And many people think heart disease strikes only old men. Too often, heart disease deaths are wrongly attributed to natural causes or ailments. As a result, women are not making a personal connection to heart disease or sharing their stories.

In the United States, 1 in 3 women die of heart disease and stroke, whereas 1 in 32 women die of breast cancer. But we spend almost 10 times more on women’s cancer research. I don’t want cancer research funding to go down, but heart disease funding needs to go way up!

In addition to promoting awareness of women’s risk for heart disease, you’ve done a lot to advocate for health care equity for women.

We are decades behind in our knowledge about what works for women with heart disease compared to men because clinical trials have traditionally included more men than women. I remember learning how different heart attacks in men and women can seem, and how frequently women are misdiagnosed as a result. To ensure that trials consider the differences between the sexes, I encourage women to participate. And I plan to keep urging and advocating until we make real progress in securing the education, research and funding needed to properly diagnose and treat women’s heart disease.