Inés Pineda-Torra (Madrid, 53 years old) does not stop laughing throughout the interview. Because she wants to take the drama out of some issues, because it is her way of facing situations that she has experienced during her professional career, and also because has just received one million euros from the insurer AXA to investigate the cardiovascular risk of women during menopause. By training in biochemistry, she studied at the Complutense University of the Spanish capital, but almost all of her professional activity has been carried out outside of Spain. He completed his doctoral thesis at the Pasteur Institute in Lille (France), spent his postdoctoral period in New York, first at Memorial Sloan Kettering and then at NYU, and returned to this side of the Atlantic to join University College London, where She became a research professor. “I had been in London for almost 15 years when the opportunity arose to come to Spain, Andalusian Center for Molecular Biology and Regenerative Medicine (Cabimer) from Seville. My life has changed radically,” she says.
Ask. Tell me that this change is for the better.
Answer. All my life I have worked on fat metabolism and the molecules that were involved in its regulation, but a while ago I started working with a rheumatologist and an immunologist on cardiovascular risk in women who have autoimmune diseases such as lupus. As a result of that, I realized the lack of information there is about cardiovascular diseases at the molecular level in women, because most of the studies are done on men. It is a niche that needs to be covered, but it is now that I have been lucky enough to get the financing to be able to do it.
Q. He says it and it sounds easy.
R. In one of the attempts there was an evaluator, because in my head it has to be a man who expresses that opinion, who went so far as to say: “I don’t understand why you only want to do research on women, this project is not justified.” If I want to study the effect of menopause on cardiovascular diseases, who else am I going to investigate? I have to say that the more international an evaluation committee is, the more welcome these types of projects are. And when you’re celebrating your birthday, these types of comments don’t matter to me.
Q. Tell us about your research, because it feels like we’re starting to name things in the 21st century.
R. Cardiovascular diseases are the leading cause of death in women, but prevention campaigns have always been linked to men. In my talks I usually show a woman having a heart attack, because it is something that is normally not seen, and there are studies that show that the time between the appearance of symptoms, the transfer to the hospital and the moment in which treats us is much longer than in men. Sometimes we do not recognize the symptoms, and other times it is because we ourselves think that we simply feel bad and that’s it. There is a higher proportion of men who suffer heart attacks, but there are also more women who suffer strokes. The problem is that, with menopause, as the levels of sex hormones alter, many things change in our body. We are no longer so protected.
Q. What a drag.
R. Our duty is to tell it. I see a lot and hear a lot from a gynecologist in the United Kingdom, Louise Wilson, who has campaigned brutally for these issues. But it is not just about identifying the symptoms, the problem is that practically all organs are affected by estrogen, which is why the effects are so diverse. For example, it’s not that we don’t concentrate during that time of our lives, it’s that the brain also produces estrogen and cognitive ability declines. There are pathologies such as anxiety and depression that are related to hormonal decline, and precisely because of ignorance, anti-anxiety drugs or antidepressants are prescribed, when perhaps hormonal treatment will get to the root. We cannot focus only on hot flashes, because there are women who do not have them. It’s not that we all suddenly start sweating.
Q. Imagine what a moment.
R. (Laughs). I remember a lot of an interview with Michelle Obama in which she said that she was in a meeting in the Oval Office and had a hot flash, because they also come to us in moments of anxiety or nerves. It’s very good that she tells it because if he were more normalized, nothing would happen because a woman asked for the air conditioning to be turned on on certain occasions without giving explanations. By the way, although I am going a little off topic, the measure of setting the temperature in public buildings to twenty-something degrees… I say that it depends on who for, because if it is 40 degrees on the street and you are five more than normal because You are pregnant or have menopause… it is as if they put you in an oven. Has anyone taken this into account?
Q. It affects our performance at work, too.
R. In the United Kingdom, a survey was carried out on this matter and published, and it occurred to me to propose doing the same in Spain. (Laugh). I will not forget the look on their faces and then told me: “These things are for the Equality Committee.” But it has nothing to do with equality, this is health.
Q. Let me go back to the time it took us to get to the hospital. Do we endure more, do we ignore our own symptoms, does our role as caregiver in society have any influence?
R. I believe there is an important factor that is the role that each woman plays in her family environment. If they are the emotional support and always put others before their own health, they will make dinner before going to the doctor. I remember a talk I attended in which a woman said that she was in a gym in New York, she was having a heart attack and she thought: “I’m very tired today, but come on, don’t be lazy.” She finished her exercise plan, she caught a plane and when she landed in London, as she continued to feel unwell, she went to a hospital and they told her that her condition was not fatigue, but a heart attack.
Q. You have said before that there are markers that are seen and others that are not. Which are?
R. There are some universals in both men and women. Having a high cholesterol level is harmful, but it is true that women up to the age of 50 have very high levels of good cholesterol and we are relatively protected. But from that age onwards, good cholesterol drops a little and it is the bad cholesterol that skyrockets. Then there are others such as blood pressure, obesity… Those that are not known, despite some, are intrinsic to women. Complicated pregnancies, premature births, births with babies smaller than normal, preeclampsia, hypertension during pregnancy… This is known to have an effect, but we don’t know how. There is much to do.
Q. What role do primary care professionals or specialists play here?
R. Even among health professionals, there is enormous ignorance about menopause. With this research I have two objectives: to give it visibility and that when studies are done on women they do not focus only on motherhood. I have nothing against those who research reproduction, but there are more things! It is not something that affects a certain group, it happens to all of us who reach a certain age, and to some even before. Another thing I want to achieve is to generate the knowledge to develop the tools that allow us to evaluate cardiovascular risk in a much more detailed and precise way. All this, in any case, has changed thanks to legislation.
Q. Tell me.
R. In the United States, the NIH (National Institute of Health) ordered in 1993 that no study be funded that was not proposed in either men or women, and even in male and female animals. And if not, it must be justified. That decision represented a radical change. It is also done in Europe, but at the national level… well.
Q. On her social networks she claims to improve the conditions of public researchers and criticizes gender bias. Before turning on the recorder he was talking to me about how much it irritates him that people refer to you as “the girls” or “the girls.”
R. It makes me sick. Do you know that in Spain there are still research funding agencies that do not take pregnancies into account in women’s scientific careers? Thus it is very complicated to comply with depending on what requirements. That no longer happens in civilized countries and it shocks me that here we still have to fight for it.
Q. And how is that fixed?
R. Touching the money. Years ago, a program was created in the United Kingdom to promote women in science, but no one paid any attention to it, until the director of the health research agency arrived and said: “From now on we do not fund any universities.” that does not have this seal of evaluation and gender perspective.” The moment you touch the money everyone gets excited. A lot of plans emerged!
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