Quality of life for women an issue

Canadian researchers find that in some matters of the heart, women do not fare as well as men

VANCOUVER, October 25, 2011 /Canada NewsWire/ - A Heart and Stroke Foundation study has found that women under age 55 fare worse than their male counterparts following a heart attack - and their health status declines more than that of their male counterparts after one month.

The AMI55 study found that women between the ages of 20 and 55 had significantly worse physical limitations, more recurrences of chest pain, and worse quality of life than men one month after a heart attack - and, compared to their baseline scores, declined in the areas of physical limitations and recurrences of chest pain. Among men, only physical limitations worsened from baseline to one month.

"While the high prevalence of traditional cardiac risk factors like diabetes, smoking, and high blood pressure contribute, they do not fully explain the poorer outcome in women," says Dr. Karin Humphries, Heart and Stroke Foundation Professor in Women's Cardiovascular Health at UBC. "This is why our study focuses on exploring non-traditional risk factors such as depression, anxiety, and social support."

Dr. Humphries attributes the slower recovery of women in part to prevalent social and cultural standards that typically place women in this age group in the role of primary caregiver.

"These women are likely not getting the support they need to recover from a heart attack," she says. "Women are less likely to attend cardiac rehabilitation than their male counterparts even when they are referred. We need to help women overcome their barriers to this essential part of their recovery."

Explanations for the difference in outcomes, she says, may be that women are presenting to hospital later, are less likely to believe they're having a heart attack, are more likely to put off seeking treatment and often ignore or under-report their symptoms. Additionally, they are less aggressively investigated for heart disease.

She adds that outcomes in younger women could likely be improved by increased awareness of risk factors and of heart attack symptoms.

The study looked at 286 patients 55 years of age or younger, including 75 females, from five B.C. hospitals. Researchers collected baseline data when patients arrived following a heart attack, and followed up on demographic, clinical, and psychosocial characteristics at one, six, and 12 months.

In B.C. alone, more than 1,000 adults under age 55 are admitted to hospital each year following a heart attack. Of these, 25 per cent are women.

"Our findings show that there is still a lot of room for improvement," says co-researcher Mona Izadnegahdar, a PhD candidate in epidemiology at the UBC School of Population and Public Health. "We can improve these odds by increasing awareness of warning signs and symptoms of heart attack, recognizing and managing cardiac risk factors, as well as knowing about and accessing cardiac resources such as rehabilitation programs."

The researchers also found in the same group of patients that, while chest pain was the most common heart attack symptom in both men and women, the women suffered a higher severity of chest pain. They also had a wider range of other pain symptoms than men, including neck and throat pain, and left arm and shoulder pain.

"This research is consistent with other studies suggesting that women suffer worse quality of life with a diagnosis of heart disease," says Heart and Stroke Foundation spokesperson Dr. Beth Abramson. "Heart disease is a leading cause of death of women in Canada. Being aware of the warning signs and acting on them quickly can save lives and improve health outcomes."

She says that women and their family members should talk to their doctors, be aware of any symptoms, and understand that heart attacks can happen to them too.

Dr. Abramson encourages women to find out how they can protect their heart health through the Foundation's The Heart Truth™ campaign (thehearttruth.ca), which educates women about identifying their risks and warning signs of heart disease and stroke, and shows them how to make lifestyle changes and take action to reduce their risk by as much as 80 per cent.

The warning signs of a heart attack - for women and men - are:

...Chest discomfort (uncomfortable chest pressure, squeezing, fullness or pain, burning or heaviness)

...Discomfort in other areas of the upper body (neck, jaw, shoulder, arms, back)

...Shortness of breath

...Sweating

...Nausea

...Light-headedness

If you are experiencing any of these signs, call 9-1-1 or your local emergency number immediately.

The study was presented at the Canadian Cardiovascular Congress 2011, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.

Simple lifestyle changes can add a decade or more healthy years to the average lifespan of Canadians, says international expert

Sharpened focus on prevention strategies would save billions of dollars in health costs

VANCOUVER, October 21, 2011 /Canada NewsWire/ - Health prevention strategies to help Canadians achieve their optimal health potential could add a decade or more of healthy years to the average lifespan and save the economy billions of dollars as a result of reduced cardiovascular disease, says noted cardiologist Dr. Clyde Yancy.

Dr. Yancy, who will deliver the Heart and Stroke Foundation of Canada Lecture at the opening ceremonies of the Canadian Cardiovascular Congress in Vancouver this Sunday, will tell delegates that people who follow seven simple steps to a healthy life can expect to live an additional 40 to 50 years after the age of 50.

"Achieving these seven simple lifestyle factors gives people a 90 per cent chance of living to the age of 90 or 100, free of not only heart disease and stroke but from a number of other chronic illnesses including cancer," says Dr. Yancy, a professor of medicine and chief of cardiology at the Northwestern University's Feinberg School of Medicine. He is also the past-president of the American Heart Association.

"By following these steps, we can compress life-threatening disease into the final stages of life and maintain quality of life for the longest possible time." He predicts that, if we act now, we can reverse the tide by 2020.

According to the Heart and Stroke Foundation, every year in Canada about 250,000 potential years of life are lost due to heart disease and stroke, which are two of the three leading causes of death in Canada.

Canadians can achieve optimal health, says Dr. Yancy, by following these steps:

1. GET ACTIVE: Inactivity can shave almost four years off a person's expected lifespan. People who are physically inactive are twice as likely to be at risk for heart disease or stroke.

2. KNOW AND CONTROL CHOLESTEROL LEVELS: Almost 40 per cent of Canadian adults have high blood cholesterol, which can lead to the build up of fatty deposits in your arteries - increasing your risk for heart disease and stroke.

3. FOLLOW A HEALTHY DIET: Healthy eating is one of the most important things you can do to improve your health - yet about half of Canadians don't meet the healthy eating recommendations.

4. KNOW AND CONTROL BLOOD PRESSURE: High blood pressure - often called a 'silent killer' because it has no warning signs or symptoms - affects one in five Canadians. By knowing and controlling your blood pressure, you can cut your risk of stroke by up to 40 per cent and the risk of heart attack by up to 25 per cent.

5. ACHIEVE AND MAINTAIN A HEALTHY WEIGHT: Almost 60 per cent of Canadian adults are either overweight or obese - major risk factors for heart disease and stroke. Being obese can reduce your life span by almost four years.

6. MANAGE DIABETES: By 2016 an estimated 2.4 million Canadians will live with diabetes. Diabetes increases the risk of high blood pressure, atherosclerosis (narrowing of the arteries), coronary artery disease, and stroke, particularly if your blood sugar levels are poorly controlled.

7. BE TOBACCO FREE: More than 37,000 Canadians die prematurely each year due to tobacco use, and thousands of non-smokers die each year from exposure to second-hand smoke. As soon as you become smoke-free, your risk of heart disease and stroke begins to decrease. After 15 years, your risk will be nearly that of a non-smoker.

A call for focused prevention strategies

While this goal of optimal health has been achieved by fewer than 10 per cent of the population, "it demonstrates the striking potential that prevention has if it is broadly embraced," says Dr. Yancy. "We know how to prevent heart disease and stroke - we now need to build the tools to empower our citizens to manage their risk and prevent heart disease."

Dr. Yancy calls on governments to invest in steady and focused prevention strategies. He says that necessary initiatives include a change in current sodium policies, continued progress in tobacco control initiatives, increased green space, and health education.

"Healthy living is key to preventing heart disease and stroke," says Bobbe Wood, president of the Heart and Stroke Foundation of Canada. "The Foundation is committed to raising awareness about heart health and to promoting public policies that facilitate healthy lifestyles and communities."

She says that the Foundation will continue to build on partnerships and policies that have led to a significant reduction of trans fats in the Canadian food supply; stronger tobacco control initiatives; healthy community design; and a continued reduction in the amount of salt in our food products, which has been achieved in part through Health Check™, the Foundation's flagship food information program.

Dr. Yancy adds that improved access to health care that focuses on prevention and control of important risk factors including high blood pressure, high cholesterol and diabetes is also key.

Raising the alarm over looming costs of treating heart disease

Dr. Yancy will also raise the alarm over the looming cost of treating heart disease now and in the future.

With predictions that the direct medical cost of treating heart disease in the U.S. alone could climb to $818 billion in 2030, he says there is a health and economic imperative for governments and societies around the world to embrace prevention strategies.

Heart disease and stroke cost the Canadian economy more than $20.9 billion every year in physician services, hospital costs, lost wages and decreased productivity.

"The opportunity for prevention is not an unrealistic expectation," says Dr. Yancy. "Over the past 40 years the rates of heart disease and stroke have steadily declined."

The rate has declined in Canada by 70 per cent since the mid-1950s. In the last decade alone, the rate has declined by 25 per cent.

Unfortunately, says Dr. Yancy, these benefits may be short-lived if the burden of risk, specifically obesity and diabetes, continues to grow, especially in children. "We need to act now."

Canadians can take a personalized My Heart&Stroke Risk Assessment™ to find out how their age, family history, and medical conditions affect their heart health at heartandstroke.ca/risk.

Heart and Stroke Foundation of Canada Lecturer Dr. Clyde Yancy will deliver the Heart and Stroke Foundation of Canada Lecture at the opening ceremonies of the Canadian Cardiovascular Congress (CCC) in Vancouver this Sunday.

Co-hosted by the Canadian Cardiovascular Society and the Heart and Stroke Foundation of Canada, CCC is Canada's largest scientific conference, attracting close to 4,000 heart-health professionals from across the country.

Attendees representing 20 different organizations, including surgeons, pediatric specialists, cardiologists, nurses, rehab professionals, and others learn about the latest science and cutting-edge research, and take it back to their patients. The Congress runs until October 26.

Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect Foundation or CCS policy or position. The Heart and Stroke Foundation of Canada and the Canadian Cardiovascular Society make no representation or warranty as to their accuracy or reliability.

The Heart and Stroke Foundation ( heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy.