125. How is your heart? Cardiovascular disease in midlife women

Are you taking care of your heart—but still feeling like something’s missing?

So many midlife women focus on breast health or hormone balance, yet don’t realize that cardiovascular disease is the leading cause of death for women. And the truth? It's not just about cholesterol. In this powerful and eye-opening episode, I’m joined by Angie Gallagher, cardiac rehab expert turned functional medicine coach, to talk about the real root causes of heart disease—and what you can do to prevent it.

Whether you’re already prioritizing your health or feeling totally overwhelmed, this conversation will leave you feeling empowered, informed, and ready to take action in a way that aligns with your life (and your nervous system!).

In this episode:

•  Why heart disease in women is not just about cholesterol
• The roles of inflammation, oxidative stress, and nervous system imbalance in heart health
• Why stress alone can trigger heart attacks—and how to recognize hidden stress
• How to build a realistic, joyful exercise routine that supports heart health
• The surprising impact of food sensitivities on your energy, brain fog, and heart rate variability
• What "getting your macros right" really means for metabolism in midlife
• Simple ways to regulate your nervous system without adding more to your to-do list

 Angie Gallagher is a clinical exercise physiologist, Functional Medicine Wellness Coach and Certified Heartmath Practitioner. For 25 years she worked in cardiac and pulmonary rehabilitation and learned what doesn't work to truly reduce cardiac risk. She now enjoys using her passion for functional medicine in her own wellness coaching business where she does both group and one on one wellness coaching to help people achieve their most optimal health from the inside out. She has learned that the gut is the gateway to health and disease. She has helped people improve physical and mental health through healing the gut and optimizing metabolism. She’s passionate about lifestyle medicine and exemplifies this in her own life through creative healthy cooking, trail running, cycling, yoga, meditation and community.

Resources Mentioned:

Angie’s Email: angie@heartwellnesscoaching.com

Social Media Links

https://www.facebook.com/heartwellnesscoaching

https://www.tiktok.com/@heartwellnesscoach

https://www.instagram.com/heartwellnesscoach

https://studio.youtube.com/channel/UCk-sjqEPBO-LP01byq0hW0A/videos

Link to Freebie

Transcript

Sara Poldmae: 0:01

Sarah, welcome to menopause. Rise and thrive. I am Dr Sarah pulled May, and this podcast is your go to guide for navigating perimenopause and menopause. If you are feeling a little overwhelmed, trust me, you are in great company each week, I'll bring you expert advice, raw, honest conversations and simple tips to help you stay grounded and maybe even find some humor in the process. Let's rise, thrive and tackle this wild ride together. Hi ladies, welcome back to the show. Today. I have Angie Gallagher joining us, and she has all sorts of wisdom to share with you. So I can't wait to dive into this episode.

Angie Gallagher: 0:44

Welcome Angie. Oh, thank you so much for having me. I'm happy to be here.

Sara Poldmae: 0:48

Yeah. So we're going to talk about cardiac metabolic health and what women need to know about risk factors and all things cardiometabolic so let's dive in. Tell us a little bit about how you got involved in this, this big field.

Angie Gallagher: 1:06

Yeah, so I spent 25 years working in cardiac rehab, and over that time, I learned what works and what doesn't work to truly identify and reduce risk for cardiovascular disease. But what happened was I started understanding more about the functional medicine approach to heart disease, and truly diving into the real root cause of heart disease, and basically all chronic diseases. And in the western medicine model, we really weren't addressing it at that level. It was very much a band aid approach. Let's give you medications for all of these various risk factors, but let's not really understand why the risk factors are there to begin with. And when I learned about functional medicine, I was like, that's really where I need

Sara Poldmae: 1:47

to be. Yeah, I love that. Okay, so what are some important things for midlife women to know about cardiac disease?

Angie Gallagher: 1:56

Yeah, well, so heart disease is not just a it's not a cholesterol issue, and I think that that is still a message that is very, very misunderstood. I mean, I think most people still think that it's a cholesterol problem and it's it's really not. We really need to understand that cardiovascular disease is a metabolic oxygen and oxidative stress issue. There's, you know, an inflammatory issue. I mean, we need to look at, what are the inflammatory triggers, what are the metabolic imbalances, and what is the oxidative stress burden going on in your life? And then add to that, the nervous system and a nervous system that's out of balance, and being in that fight or flight side of the nervous system is going to cause problems in each of those areas that I mentioned. So when I work with people, I really try to help them understand let's not just look at cholesterol as this very, very shallow, limited approach. Let's look at let's dive deep into those different cardiovascular labs. Let's look at your inflammation, your inflammatory markers, metabolic health and oxidative stress. And people are like mind blown because they're just like my doctor just said, it's a cholesterol problem,

Sara Poldmae: 3:03

right? So what can women do to reduce their cardiovascular risk?

Angie Gallagher: 3:11

Well, so what I what I try, what I've been going around and just shouting from the rooftops is, let's better understand what risk looks like. Let's better understand what your true risk so what is, what does it look like? What does it feel like? What are the lab values that tell you you have good metabolic health? What about inflammation? What about oxidative oxidative stress? So I if people are willing to ask their doctor, or they can work with a functional medicine provider like myself, and we can get those labs drawn to tell you what's going on. Do you have inflammation? Inflammation? Do you have metabolic imbalance? Are you insulin resistant? Do you have imbalances in your nervous system? Are you in your fight or flight most of the time, and you're so used to it that you don't recognize it as stress? Is there oxidative stress happening inside the body? There's labs that can tell us that. So I encourage people to know their numbers, because if you don't know your numbers, you don't really know what you're trying to achieve. So starting with knowing the numbers. But even if you don't want to spend the money or the time on lab work, there are definitely some things that you can start doing right away. One of those is limiting getting your macros dialed in. Many of us are very carb focused. We get up in the morning and we have a bagel or an English muffin or oatmeal. You know, people will like, you know, they want to fight to the death to eat their oatmeal because they've been told for years that it's the healthiest breakfast. But when we start our day with a big bunch of carbs, we're we're setting ourselves up for poor metabolic health. So really getting those macros dialed in, and that's what I work with people a lot on, but starting the day with a lot of protein, veggie omelet, you know, Greek yogurt with some berries and nuts would be a much better start to the day, and just not basing your whole day on carb heavy foods. This is going to really improve your metabolism. That's just a simple, simple thing. Get Started.

Sara Poldmae: 5:00

Okay, so that's diet. What about what do you counsel women on for exercise?

Angie Gallagher: 5:05

For Yeah, so exercise. Exercise is super important, as many of our, you know, podcast or longevity podcast hosts will talk about muscle is the is the currency of longevity. We've got to have muscle. We've got it. And, you know, especially as we work into perimenopause menopause, we got to go into those years having good muscle. And so I do talk to my clients a lot about setting up an exercise regimen that works for you and include something that, you know, some heavy lifting. You don't have to go to the gym, you don't have to spend hours, you know, pumping iron in that kind of traditional sense, but have something that works in your life. So whether you have some dumbbells and a kettlebell and you do that while you're watching your favorite Netflix show in the evening, or whether you start your day, but you have to have something that works for you. I you know, I tell people, if it's if, if it's something that you think you should do but you don't really want to then it's, chances are you're not going to do it. You got to find the thing that you like. Find a workout buddy. I trail run. I'm a huge fan of getting into nature. I think it's really balancing for the nervous system. So if you can get into nature, if you need a workout buddy, a hiking accountability buddy, then find them. Get that person.

Sara Poldmae: 6:18

And that actually goes to my next question, the nervous system regulation. So you could be killing two birds with one stone if you're exercising outside, yeah, helping your nervous system. Can you talk a little bit more about your nervous system in relation to your heart health?

Angie Gallagher: 6:34

Yes, 100% so yeah, this is one of my favorite topics. I am also a Heart Math practitioner, and Heart Math is a technology where we look at the pattern created by the timing between your heartbeats, and that is really indicative of your nervous system balance. It's, it's crazy cool science. You can go to heartmath.org, and learn all about the science behind this, but we can, I can put a sensor on somebody, and I can tell in real time where they're at in their nervous system balance and and I've been studying this for for the last like couple of decades. When we have good heart rate variability, meaning it's generally high, that means we have a more balanced nervous system. And the the science is, is very clear that the better our nervous system is regulated, the lower our risk for cardiovascular disease. I had, I had patients, female patients, coming into my cardiac rehab program that were otherwise very healthy. They were fit. They exercised regularly. They didn't really have any classic risk factors, but they were highly, highly stressed. And they had, they had a heart attack, you know, they, they, and some of them had, you know, pretty massive left anterior descending blockages, and it was just the only thing going on in their life was stress. So we've really got to get that. We've really got to get that figured out. Getting, you know, having a wearable device that gives you some feedback and tells you where you're at can be helpful, but also just having your strategy. And as you said, getting out into nature, it's, it's, yeah, there's science. There's plenty of science that tells us that when we get into nature, our nervous system is immediately calmed. So I,

Sara Poldmae: 8:11

I studied at a herbert Benson's Mind Body Institute at Harvard. Gosh, it's probably been more than 10 years. Might have even been 15 years ago, but he was showing us case studies on Tibetan monks and how they can slow their heart rate through meditation and basically clinical studies that showed that meditation is just as impactful on cardiovascular Health as cardiovascular exercise, which I thought was fascinating back then, and now, you know, fast forward many years later, it makes even more sense to me now that I've been in clinical practice for 20 years, and I am, you know, astounded by the levels of stress that the women that come into my clinic in midlife, are carrying with them, yes, and you know, we can do all the blood work in the world, and I think there are clinical labs, some that are more valuable, in my opinion, than others, but we can do all of the lab work. But frankly, if you are chronically stressed, yeah, you don't need labs to tell you that, right? Like that is a an indicator that problems are coming. Yeah, and, you know, I just did an episode on this a couple episodes ago. It's like, you know, we can do all the functional medicine labs, and they are valuable for a lot of different things. They can be life changing, but managing your stress and figuring out the tools that you can use to manage your stress. It's not about, and I'll go on a little bit of a tangent here. It's not about getting the stressors out of your life, because oftentimes the things that are in our lives that are stressing us out aren't going away in their future. It's about teaching your body that you're safe. Yeah. And completing that stress cycle. Yeah, so it's not about my life is stressful, but that will change in five years, so it'll all be okay. That's setting yourself up for failure. Yes, 100% Yeah.

Angie Gallagher: 10:13

I've had several clients that they that, you know, they were buying all the books, they were doing all the time, they were doing all the things. But I'm like, you're just doing, doing doing. You're adding more things to your list of things to do. And really what needs to happen is you need to do less. You need to figure out how to manage your stress and do less and be more. And I just did a Heart Math session with someone the other day, and she's another entrepreneur, and trying to build her business. And she right away she could see, I mean, it was just like she felt like this was just like this epiphany of, oh my gosh, like, I'm not breathing, I'm not breathing, I'm shallow breathing. I'm holding my breath most of the day, white knuckling my life, and just having that session on the heart mouth to see what was happening with her nervous system was was illuminating enough for her to realize I've got to, I've got to figure it, figure this out. I've got something, you said, Tell my body that it's safe so and I like, yeah,

Sara Poldmae: 11:12

situation. Sorry, go ahead.

Angie Gallagher: 11:14

No, no. I was just saying nature is, is one way to do that, you know, to access that. There's so many ways to do it, but I'm a huge nature nerd, and I just think that that's one place that we can go and immediately start to feel a calm, you know, a calm, calming sense. But if you don't have access to get into a natural place right away, then, of course, there's lots of other tools, meditation being one really important one.

Sara Poldmae: 11:39

Yeah, absolutely, there's so many choices out there. And I think part of the beauty of midlife, and this isn't necessarily cardiovascularly related directly, but could certainly apply, is one of the reasons I'm so passionate about this time of a woman's life, is it's really a time where we can step back and reflect on what's important to us and what we enjoy. Because so many women come into my clinic and we, you know, we ask questions that a typical doctor's office won't ask, and some of it, it's about like, what brings you joy and what are your hobbies? And a lot, I would say most, 90% of the women don't really know anymore. They've kind of lost that part of themselves. So if you don't know what to turn to that's joyful, like a run outside, or your animals, or, you know, what have you, if you don't know what truly brings you joy and peace, it's really hard to step outside of that stress cycle.

Angie Gallagher: 12:40

Oh, I know. And you're right. So many of the women that I have worked with, they have given everything to everyone else in their lives. And when you say, what is your hobby like? I don't know, who has time for a hobby, you know? And then where parents are aging, and then you still have kids that need you, and you feel like you're pulled in a million different directions. I mean, that's those are the women who just really need as much as possible to find those outlets to give Hunter back, give back to themselves.

Sara Poldmae: 13:09

Yeah, that's so true. So we've kind of gone through the gap. We've gone through diet, although we only talked about macros, and I would challenge that. That is definitely one of the core principles. But there is more to it than that. Yeah, you know, with macros can be very different. So the macros in a donut, yeah, can be very similar to eating french fries and a banana, the same size, and those are not equal. Now, mind you, I don't want you to just eat, you know, I don't want you to just eat a banana. I want you to add the protein and I want you to get the rats up, you know, all that good stuff. However, there is more to nutrition than just the macros. And eating whole foods and eating foods in, you know, different orders and eating foods together versus separate. There's so much to it. Is there any other wisdom in the dietary world that you would like to

Angie Gallagher: 14:02

impress so much. It's just hard to, I mean, it's such a huge topic, it's hard to really like bring it down into something I can share in a couple of minutes. Of course, Whole Foods. I mean, just shopping around the perimeter of the grocery store and coming home, you know, arriving to the checkout stand with a cart full of produce, clean, healthy, you know, ideally grass fed, wild caught proteins, all the fruits and vegetables and, you know, really limited stuff coming out of packages and boxes. I, you know, I'm, I'm of the mindset that we are all very different. We're all in our own ecosystem. There is no one size fits all. I'm not a big proponent of everybody should be vegan or be a carnivore, but we need to know our own DNA, and we need to know how our body does best. So in my program, I have everybody, when they do my my health transformation program, everybody does the same kind of detox cleanse, where we just take out a lot of a lot of the stuff that is for a lot of people. Processed foods. And we really just focus on on proteins, vegetables and fruits, and then we bring things back in in a very systematic, methodical way, so that people can really identify how their own body does with these different foods. Some people do find, yeah, that they just, you know, they they were having a lot of inflammatory issues that they didn't know is related to, say gluten, for instance. And I, you know, I'm not saying that everyone should give that up, but when people take certain things out, and they feel what it feels like to feel really clean and light and like no inflammation, and they've released bloating and toxins and extra weight, then they can then they know what that baseline feels like. And then when they bring things back, they're like, oh, I don't feel so good when I have corn or, you know, whatever it might be. So, yeah,

Sara Poldmae: 15:44

100% unaware for me that you say that, because people don't always know what's what's affecting them and how, and that's where functional medicine can really help you. In fact, I just did a food intolerance test, and I've always had issues with gluten, so I wasn't going to be surprised when that showed up. I knew, you know, I'm not, I go in and out of gluten free, but I always kind of watch it, and I know if I start to get a little brain foggy, that I've probably been like, not watching it closely enough, that kind of thing. Well, I did this food intolerance testing, and I came back so much more reactive to dairy, which I've never, ever suspected. And a couple, about a month and a half ago, I lost the charger for my whoop which tracks your heart rate variability. And so I was like, Oh, well, you know, I kind of put I wear it, and then I start to get in my head about what the that wearable is, and tracks your heart rate variability and tracks your sleep. And so I was like, you know, it's probably good that it's not in my life right now, like, I let it go so that I can, like, just see how I'm feeling in the morning, rather than let my technology know how I'm doing. But my heart rate variability was much lower than I wanted it to be, and it was starting to really weigh on me. And now I'm I'm going to order another battery, because I'd really be interested to see if my heart rate variability has changed now that I'm not eating all of the foods that were causing inflammation. Yeah, and, you know, I'm just going to be interested when I put it back on, because I think if that's the only factor that's significant that's changed for me since I wore it last, it'll be interesting to see. And this is where, again, functional medicine programs like yours and mind can really help people is because we're looking outside of the box. Because dairy may be a perfect food for certain people, but for people like me, for some reason, my body triggers a huge inflammatory response when I eat dairy. I never knew it. All I knew was that I was exhausted at 2pm every day. It's easy to blame that on stress. It's easy to blame that on a lot of things, but I can tell you, it's been a week and a half and it's life changing. So I really want to encourage people to they have the resources. Not everybody does, but if they have the resources to have these types of testings done, it can be really life changing.

Angie Gallagher: 18:00

Oh my gosh, yeah. I have a client that did it. She she did my program, and she took a bunch of things out and started feeling a lot better, and her migraines that she was having hormonally, got much, much better, but they never fully ran away. So she decided to do food sensitivity testing, and several things that she was still eating, she realized, like, oh my god, they're like, bright red on food sensitivity. So she's taken them all out, and she says she has finally had a cycle with no migraine, yeah,

Sara Poldmae: 18:29

laughing, yeah,

Angie Gallagher: 18:31

yeah. It's, yeah, eating, how food?

Sara Poldmae: 18:34

Yeah, it really is. It is. And some of the things that show up, like randomly, I'm, I'm very, very highly reacted to pomegranate siege, which I love, not very hard to give up, because they're not a staple of a diet, but and pistachios, which I love as well. But anyway, so giving those foods up, you know, it can really be life changing, and so it's not only symptomatically, but think of what's going on inside of your body if you're having those inflammatory triggers, right? You know, there's only so many labs that can measure there's a lot going on under the surface that science has not figured out yet. So I think it's, it's so valuable the work that you're doing. So tell the audience how they can get in touch with you. A little bit more about you and your program before we wrap up, because I want to make sure that they can get in touch with you. Yeah.

Angie Gallagher: 19:19

So heart wellness coaching is my website, and they can go there, and there's links in there to send me an email or to set up a free consultation, and then the I'm on Facebook as heart wellness coaching. I'm on Instagram as heart wellness coach. Tiktok has heart wellness coach. So few different platforms there.

Sara Poldmae: 19:39

Great, yeah, I'll make sure to follow you. Well, this has been amazing. I know we wanted to keep it really positive for women, because this is a podcast about empowerment, but I think it would be remiss not to mention that heart disease does kill so many more women each year than breast cancer, and so we have to take. It seriously. Not every woman knows that. You mentioned it to me before in the pre interview, what have you. And I think that it's really important that we take our heart health seriously. Because I think the messaging was more for men earlier on, it has been, yeah, it's just as important for women to be looking at this.

Angie Gallagher: 20:19

Yeah, it absolutely, and not just, I mean, it's like heart disease, you know, we have to remember that it is, it's the root of it is vascular. It's, you know, it's disease in the arteries that feed the heart. If there's disease in the arteries that feed the heart, then there's likely disease and arteries that feed the brain, that feed the kidneys, that feed the liver. I mean, so it's vascular diseases. Is not Gen it's generally specific. I mean, it could be in the legs, causing peripheral vascular disease. So you're reducing risk for heart disease means you're also reducing reducing risk for stroke, for kidney issues, you know, for for high blood pressure. So, you know, we really want to make sure we're aware of that the risk is can be bigger, and so the same efforts to reduce thinking, to reduce the risk for all these other issues.

Sara Poldmae: 21:09

So, yeah, absolutely. Like you mentioned migraines. You don't think of migraines and heart being connected, but they very much are, like, we're all connected in every way, shape. Yes, it's nothing isolated and so beautiful. Yeah, 100% Well, thank you so much, Angie, for being on the show. I've really enjoyed our chat, and we will put all of your links in the show notes, and I hope some of our audience members reach out to you. Thank you so much. It's been my

Angie Gallagher: 21:36

pleasure. Thank

Unknown: 21:42

you.