When Dr. Frank M. Reid III, senior pastor at Bethel AME Church, said "bless your heart" to his congregation this Sunday, he meant it literally.
It was Red Dress Sunday at the church off Druid Hill Avenue, an annual event launched in Baltimore by St. Agnes Hospital to raise awareness of the dangers of heart disease. It's the number one killer of women in the United States, and an even greater danger to African-American women.
The Baltimore event, which localizes a national movement, began a decade ago with three city churches and has since expanded to 130.
The women in the pews were predominantly African-American women clad in red shirts, skirts, dresses, hats and even hair for the occasion. By dressing for the occasion, they were agreeing to take the issue seriously by getting checkups, eating healthier and exercising.
"Tens of thousands of people we are reaching today with a life saving message," Dr. Carlos Ince, chief of cardiology at St. Agnes, told the congregation. "One woman dies every minute in the United States of heart disease and about half don't even know they have the disease."
Dignitaries from the city and state, including Baltimore Mayor Stephanie Rawlings-Blake and U.S. Sen.Ben Cardin, also reminded the women about what was at stake.
"Take care of your family, but first take care of yourself," Cardin said after thanking others, including President Obama, for passing the Affordable Care Act , which aims to make cheaper and better insurance more widely available.
On regular diet and exercise, Rawlings-Blake said, "I wish I could tell you that it is easy, but it's not."
Someone who heeded the warnings and made the changes was Georgetta Thomas, a 61-year-old from Woodlawn, who said she found out after a routine exam she had three blocked arteries.
She underwent triple-bypass surgery two years ago and has since altered much of her routine to include water aerobics and eating more fruits, vegetables and whole grains. She said she's lost 45 pounds.
"I wear a scar on my chest as a constant reminder of how important it is to take care of your heart," Thomas said. "I'm stronger, wiser and better than I was two years ago."
Thomas speculated that many women skipped the doctor because they feared the cost. She said she hoped national health care reform would change that. She also said African-American women in particular may culturally rely more on home remedies they grew up with, rather than visiting a doctor.
Many women also never have symptoms of heart disease. And when they do, some don't realize what they are, said Dr. Shannon Winakur, medical director of the Women's Heart Center at St. Agnes, who visited the church to answer questions. She said they don't even recognize when they are having a heart attack. Symptoms include chest pain, heartburn, nausea and shortness of breath.
That makes screening important, Winakur said.
She said risk factors included high blood pressure and cholesterol, smoking and a family history of heart trouble. Diet, exercise, maintaining a healthy weight and quitting smoking decrease the risk of a heart attack by 80 percent, she said.
Raising awareness is crucial, she said, especially among African-American women, who research shows have higher rates of obesity and diabetes, putting them at higher risk for high blood pressure and heart disease.
National statistics show heart disease kills just as many women as men, according to the U.S. Centers for Disease Control and Prevention. It caused more than 292,000 deaths among U.S. women in 2009. But the disease disproportionately killed more black women — or 7.6 percent among African-American women compared with 5.8 percent of white women.
Winakur and others urged congregants to attend a health fair following the service, where women would get their blood pressure checked and learn about prevention, early detection and treatment of disease.