Ladies, listen!
“If there’s one message I want women to hear loud and clear, it’s that they need to be aware of their heart health,” says Dr. Beth Abramson, cardiologist and associate professor of medicine at the University of Toronto. “Just like we have our yearly Pap screening and mammogram, every woman needs to have her blood pressure and cholesterol levels checked annually.”

Dr. Abramson delivered this message to an audience of health care professionals at the Canadian Cardiovascular Congress this past October. She and her colleague Dr. Susan K. Bennett from George Washington University Hospital in Washington D.C. are spokeswomen for the Heart and Stroke Foundation’s The Heart Truth, a public education campaign to raise awareness about heart disease and stroke among Canadian women and their health care professionals.

Identify the warning signs
Many women are simply not familiar with heart disease and most do not recognize the warning signs of a heart attack or stroke. Women often experience the same symptoms as men but are less likely to believe they're having a heart attack, and tend to put off seeking treatment.

Warning signs of a heart attack include chest pain or discomfort; pain in the arm, neck, jaw, or back; nausea, indigestion or vomiting; sweating and / or cool, clammy skin; or difficulty breathing.

Sudden discomfort or pain in these areas, that does not go away with rest, can indicate a heart attack. Pain may feel like burning, squeezing, heaviness, tightness or pressure. Studies report chest pain as the most common sign of a heart attack for both sexes, while women are more likely to experience the other warning signs. For women, onset of pain may not be the first sign of heart trouble: some report unusual tiredness, trouble sleeping, problems breathing, indigestion, and anxiety up to a month before the heart attack.

Warning signs of a stroke are the sudden onset of: weakness or numbness; trouble speaking; vision problems; severe headache or dizziness. If you experience any signs of heart attack or stroke, seek medical attention immediately! Call 9-1-1 or your local emergency response number. Fast action increases your chances of survival and recovery.



Stroke and migraines can have similar symptoms but there are three key differences: firstly, stroke involves the immediate onset of symptoms, whereas migraines take minutes or hours to establish. Loss of vision is common in stroke, while migraine’s visual disturbances usually involve flashing lights and lines. Finally, 2/3 of stroke patients are over age 65, while the first migraine often occurs before age 20. Significantly, research shows that females who experience visual disturbances during migraines are 70% more likely to experience a stroke than non-migraine sufferers, and are encouraged to minimize their risk by making healthy lifestyle choices.

Change key behaviours
Ultimately, 80% of deaths due to heart disease can be prevented by changing behaviour. The HSFC strongly suggests:
1 Stop smoking.
2 Be physically active.
3 Eat a healthy diet, low in saturated and trans fats.


Food for thought
The relationship between women and healthy eating is complex: knowledge and execution don’t always go hand-in-hand. “If finances or time are tight, we know that women will go without to ensure that their children and spouse have what they need,” says Carol Dombrow, dietician with the Health Check™ program. “The Health Check program is designed to make it easier for Canadians to make healthy choices, so that everyone eats well and benefits from overall health and well-being.” The new Canada’s Food Guide also includes specific recommendations for women by age. 

Talk to your doctor
Research shows that women’s physicians also don’t understand the magnitude of the problem. In a 2005 survey of American physicians, only 8% of primary care physicians, 13% of obstetricians/gynecologists, and 17% of cardiologists knew that heart disease was killing more women than men. This lack of knowledge contributes to poor diagnosis, especially for younger women, and less than optimal treatment. “Early detection is key, but even when heart disease is detected, women are not treated as aggressively as men and we need to explore the reasons why,” says Dr. Abramson. 

Dr. Bennett refers to this inequity as a gender gap and suggests it’s partially because physicians tend to underestimate a women’s risk. So, when primary care physicians see female patients with hypertension, high cholesterol or unhealthy lifestyle choices, they may not act as aggressively as for a male patient presenting with the same concerns. Other explanations include some evidence that women react differently to traditional heart disease medications and interventions, but Dr. Abramson is adamant that the best practice for men with heart disease is also the best  for women.

Ironically, patients may have to educate their doctors. Dr. Bennett says, "Through The Heart Truth campaign in the U.S. we recognized that the final line of the public education campaign is to get women to talk to their doctors, because the medical community has not absorbed the message about women and heart disease.” Dr. Bennett states that women should learn and understand their blood pressure and cholesterol levels from their doctor.

Take care of you
The responsibility falls to women to make healthy choices that minimize risk, to educate themselves, and to talk to their doctors about heart disease and stroke. “I often say that women are Type E personalities,” says Dr. Abramson. “They are everything to everyone except themselves. Women need to slow down and take care of themselves so that they can be around for others.”  H&L

For additional information about The Heart Truth Campaign, visit www.thehearttruth.ca