The Art Of Aging: The Heart Of The Matter

Episode of Next Question with Katie Couric · October 6, 2026 · 1 h 8 min

Katie Couric and cardiologist Stacey Rosen discuss heart disease in women, from research bias and symptoms to life-stage risks, cholesterol, testing and prevention.

Summary

In the first episode of Katie Couric's "The Art of Aging" series, sponsored by Northwell Health's Katz Institute for Women's Health, Couric interviewed cardiologist Stacey Rosen about heart disease, the leading cause of death among American women. Rosen argued that decades of excluding women from research, treating heart disease as a man's illness, and labeling women's symptoms "atypical" led to underdiagnosis and undertreatment.

Rosen described how women's heart attack symptoms often include breathlessness, back pain or fogginess alongside chest pain, and urged women to call 911 rather than drive to the hospital, and to chew four baby aspirin. The pair walked through risk factors across a woman's life: menstrual history, polycystic ovary syndrome, adverse pregnancy outcomes, perimenopause and the loss of estrogen after menopause. Rosen also explained microvascular disease and MINOCA, discussed the legacy of the Women's Health Initiative hormone therapy trial, and said menopause hormone therapy is not recommended for primary prevention of heart disease.

On prevention, Rosen outlined the American Heart Association's Life's Essential 8, sleep, the Mediterranean and DASH diets, alcohol, exercise guidelines and stress management. She discussed LDL cholesterol, ApoB, lipoprotein(a), the PREVENT risk calculator, statins, coronary calcium scoring, CT angiography and nuclear stress tests. Rosen closed by expressing optimism about AI in research, calling for more holistic, interdisciplinary care, and arguing that it is never too late to focus on healthy longevity.

Chapters

0:00
Series introduction
Couric introduced The Art of Aging series and her guest, cardiologist Stacey Rosen.
2:25
Women left out of heart research
Rosen explained why women are underrepresented in cardiovascular trials and how bias shaped diagnosis.
6:40
Heart attack symptoms and emergency response
Rosen described how women's symptoms differ and what to do during a suspected heart attack, including calling 911 and taking aspirin.
12:25
Family history and young women
The discussion covered genetics, cholesterol screening, menstrual history and PCOS as risk factors.
16:16
Pregnancy, race and perimenopause
Rosen discussed adverse pregnancy outcomes, disparities affecting Black women, and rising risk around perimenopause.
21:11
Conditions unique to women
Rosen explained microvascular disease, MINOCA and why such diagnoses were long missed.
23:57
Menopause, hormone therapy and GLP-1s
They discussed estrogen loss, the WHI trial's legacy, menopause hormone therapy, and GLP-1 drugs.
32:03
Lifestyle: diet, sleep, alcohol, exercise, stress
Rosen outlined Life's Essential 8 and practical advice on eating, drinking, moving, sleeping and managing stress and caregiving.
45:22
Cholesterol, statins and cardiac testing
Rosen covered LDL, ApoB, lipoprotein(a), the PREVENT calculator, statins and imaging tests.
56:30
Connected systems, advocacy and the future
They discussed oral health, women's self-advocacy, AI in research, public awareness and healthy longevity after 70.

Key points

What was said, by whom, with the exact words. Timestamps jump to the moment.

Stacey E. Rosen
Rosen said heart disease was historically viewed as a man's illness, so men were studied and treated while women's symptoms were minimized.
“We thought this was a man's illness. We studied men. We treated men. We even thought women didn't get the disease, so we minimized their symptoms”
Listen from 3:27 · Sex bias in medical research
Stacey E. Rosen
Rosen argued that women were excluded from early research partly because researchers doubted their ability to consent and equated women's health with reproduction.
“We didn't think they could give consent appropriately. We thought that women's health was just entirely related to reproductive health. And so we excluded them”
Listen from 6:02 · Sex bias in medical research
Linked moment · 7:57Skip to 7:57 using a listen link in the info box.
Stacey E. Rosen
Rosen said women more often than men experience additional symptoms such as breathlessness, back pain or fogginess alongside chest pain.
“Women, though, as opposed to men, will have other symptoms at the same time. So it may be a little discomfort. Women don't like to use the word pain, but mostly breathlessness”
Listen from 7:57 · Heart attack symptoms
Stacey E. Rosen
Rosen advised that anyone who suspects a heart attack should call 911 immediately rather than drive or wait it out.
“Do not wait, see if it passes by taking Tums. The moment you think you might be having a heart attack is the time to call 911”
Listen from 10:47 · Heart attack symptoms
Stacey E. Rosen
Rosen recommended chewing four baby aspirin while awaiting emergency services and telling responders you have done so.
“if you have baby aspirin in the house, take four of them and chew them”
Listen from 11:34 · Heart attack symptoms
Stacey E. Rosen
Rosen described pregnancy as a cardiac stress test and said complications like gestational diabetes raise future risk even if they resolve.
“About 5 to 10% will have gestational diabetes, blood sugar abnormalities. And even if that goes away after childbirth, you are still at higher risk”
Listen from 17:11 · Adverse pregnancy outcomes
Stacey E. Rosen
Rosen explained that microvascular disease can cause heart attack damage without any arterial blockage, a mechanism long missed in women.
“So microvascular disease can cause all the damage of heart attacks without obstruction, without a blockage”
Listen from 22:05 · Coronary microvascular disease
Stacey E. Rosen
Rosen criticized the response to the WHI hormone trial, saying it was shut down rather than recalibrated, leaving women panicked and doctors unwilling to discuss hormones.
“We shut it down. It was horrible. And then the whole concept of hormone replacement continued. got women panicked, got doctors unwilling to even discuss it”
Listen from 25:32 · Women's Health Initiative
Stacey E. Rosen
Rosen said menopause hormone therapy is not recommended for primary prevention of heart or brain disease because benefit has not been shown.
“It is not recommended for primary prevention. So no one starts it for heart and brain health”
Listen from 27:04 · Hormone replacement therapy
Stacey E. Rosen
Rosen said GLP-1 drugs have revolutionized cardiovascular medicine through effects on blood pressure, cholesterol, inflammation and blood sugar.
“GLP-1s are, you know, truly revolutionized healthcare and cardiovascular medicine”
Listen from 30:16 · GLP-1 receptor agonists
Stacey E. Rosen
Rosen said there is nothing preventive about alcohol and that less is better for heart health, brain health and cancer risk.
“what I tell people is there's nothing preventative about having a glass of wine or any alcohol. So you never start thinking it's healthy for you”
Listen from 36:02 · Life's Essential 8
Stacey E. Rosen
Rosen cited exercise recommendations of 150 minutes of moderate or 75 minutes of high-intensity exercise per week, stressing that any movement counts.
“But the recommendations are 150 minutes a week of moderate exercise. And you could still carry on a conversation when you're walking, even if you're huffing and puffing”
Listen from 38:56 · Life's Essential 8
Stacey E. Rosen
Rosen said new guidelines call for using the PREVENT calculator and target an LDL below 100.
“We want everyone's LDL to be less than 100, and that's very different than where we were in the old days”
Listen from 48:17 · PREVENT risk calculator
Stacey E. Rosen
Rosen called statins inexpensive with minimal side effects, comparing early treatment to saving for retirement, and disclosed she takes one herself.
“It's literally like saving for your future. And the medications are inexpensive, minimal side effects”
Listen from 49:17 · Statins
Stacey E. Rosen
Rosen suggested a coronary calcium score for people with risk factors, generally not before 40 unless there were pregnancy complications, family history or diabetes.
“If you have very little, probably not before 40, honestly. If you had pregnancy-related issues, then you should do it younger, you know, in your 30s”
Listen from 53:27 · Coronary artery calcium score
Stacey E. Rosen
Rosen cited a statistic that only 44% of American women know heart disease is their biggest health risk, with lower awareness among Black and Hispanic women.
“Only 44% of American women know that heart disease is their biggest health risk. And when we divide that to black women and Hispanic women, the numbers are even lower”
Listen from 58:10 · Cardiovascular disease in women
Stacey E. Rosen
Rosen argued it is never too late for prevention, noting her healthy 87-year-old mother just started a statin.
“And it's never too late. My mother just started on a statin. She is 87 years old”
Listen from 1:03:37 · Aging

People

In the conversation

Katie CouricAmerican journalist who made a documentary on Confederate monuments
Stacey E. RosenCardiologist, executive director of Northwell Health's Katz Institute for Women's Health and immediate past volunteer president of the American Heart Association

Discussed

Bernadine HealyFormer NIH director who launched the Women's Health Initiative
Rosie O'DonnellComedian and former talk show host
George BellerCardiologist and Couric's brother-in-law, credited with helping develop nuclear stress testing

Topics

From the publisher

As I get closer to my 70th birthday, I’ve been thinking a lot about what it really means to age well. That’s what inspired “The Art of Aging,” where I’m talking with leading experts about the science of living healthier, longer. In this episode, I’m joined by Stacey E. Rosen, MD, immediate-past volunteer president of the American Heart Association and executive director of Northwell’s Katz Institute for Women’s Health, with whom we are partnering for this series, to talk about heart disease, the leading cause of death in women. We discuss why women have been overlooked in cardiovascular research, the symptoms too many of us miss, and what every woman should know to better understand and protect their heart health. #NorthwellPartner Hosted on Acast. See acast.com/privacy for more information.

Summary, chapters and key points were generated from the episode transcript on October 7, 2026. Quotes are checked word for word against the transcript.

Categories: Medicine·Health & Fitness