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Canadian cardiac researchers warn women about risks of heart attack and stroke

Goal of Wear Red Day on February 13 is to arm women with knowledge, questions to ask their doctors: U of A nursing expert
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U of A researcher and the Canadian Women's Heart Health Alliance encourage women to advocate for their own heart health, and recognize signs of heart attack. Photo: Metro Creative Connection

Did you know that heart attack and stroke are the number one cause of premature death for women in Canada? Or that Canadian women are five times more likely to die of heart disease than breast cancer? Or that 53 per cent of women who have heart attack symptoms go undiagnosed when they seek medical treatment?

It’s “stunning” facts like these that Canadian cardiac researchers are hoping to get across this Valentine’s Day weekend with the Wear Red Day campaign. 

“If you ask Canadian women what they are afraid of, they will say breast cancer,” said Colleen Norris, U of A Faculty of Nursing professor and part of the Canadian Women's Heart Health Alliance, which is hosting Wear Red Day.

Norris said while women have worse outcomes from heart disease than men, two-thirds of cardiovascular research is focused on male study subjects. That’s why she recently led a project to review all of the existing evidence about women’s risk factors, disease awareness, presentation, diagnosis and treatment.

“We can’t move forward unless we know where the gaps are," said Norris.

Recognizing the signs of heart disease in women

Research found that between 2010 and 2020, 300 women per year (with heart attack symptoms) were discharged from Alberta hospitals, only to return with a full-blown heart attack within 30 days.

“These numbers are just horrendous,” she said. “And they don’t include the women who died at home.”

 Instead of the “Hollywood heart attack” symptom of extreme chest pain, women may experience only chest discomfort, sweating, nausea, shortness of breath or light-headedness.

“The big message is that it’s not in your head—no matter what age you are, you are just as likely to have heart issues as men do,” Norris said.

A heart health passport could help

The Canadian Women’s Heart Health Alliance is building education modules for medical and nursing students, so they can identify and overcome the biases that may lead to them missing the signs of heart disease in women patients. 

Norris proposes developing a “heart health passport,” which would list a woman’s medical history as it relates to her heart, so she could discuss prevention with her doctor.

“Women who have had prenatal complications such as gestational diabetes, hypertension, pre-eclampsia or protein in their urine are at significantly higher risk to develop early heart disease,” Norris said. “Getting pregnant is the first stress test you will have—it really taxes your vascular system.”

“Identifying women at risk early in their lives means that it may be possible to alter that risk,” she said.

Norris said recent research has also uncovered that women are more likely than men to have microvascular disease in the tiny vessels underneath the main heart vessels, which can’t be detected with current scans. “We don’t yet know how to diagnose it or how to treat it effectively.”

Arming women with information, good questions

Norris said that along with biological risk factors, women are also affected by barriers related to their gender roles. For example, while there is a general trend for people with heart disease symptoms to delay going to hospital during the pandemic, women are even less likely to seek treatment. 

“They are busy as front-line workers and caregivers, and they delay going to hospital for their heart symptoms because they’re afraid of getting COVID,” she said. “But they also don’t want to bother emergency staff who are dealing with the pandemic—women don’t want to bother others.”

Norris advises women who do go to hospital for heart disease symptoms to ask the following questions before they leave:

  • What do my blood pressure, electrocardiogram (ECG) and other test results show?

  • What are my risk factors for heart disease?

  • Where can I follow up if I have questions about my heart?

  • What should I do when I feel symptoms again?

“We can give you the tools to be strong and advocate for yourself,” Norris said.

Wear Red Day

Wear Red Day, a national initiative to raise awareness of women's heart health, takes place online this Saturday, Feb. 13. Sign up to watch an online lecture by Colleen Norris and other Prairie researchers entitled Sex, Gender, and Cardiovascular Disease Throughout the Lifespan.

Article courtesy of University of Alberta folio

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