Heart Health
Women make up just over half of Canada’s population, yet there’s a continued lack of awareness and understanding around women’s heart and brain health. Two thirds of heart and stroke clinical research participants are men, and when women are included, an analysis by sex and gender isn’t always done. As a result, approaches to prevention, diagnosis, treatment, and care often don’t equally apply to women.
Women’s bodies aren’t the same as men’s — and neither are their lives. Women face distinct risk factors for heart disease and stroke, including being at an elevated risk at different points in their lives, like pregnancy or menopause. Women are also more likely to experience certain types of heart and brain conditions than men and can present with different signs and symptoms of a heart attack. Shockingly, half of the women who experience heart attacks have their symptoms go unrecognized, and women are less likely than men to
receive the treatments or medications they need.
Driving positive change
Social differences also impact women’s heart and brain health. Women often put the needs of others before their own and take on most unpaid caregiving responsibilities, making negative health outcomes more likely. Compounding factors can also further affect how women receive care, including race, Indigeneity, income, and where they live.
Some progress has been made, but much more needs to be done to better support women’s heart and brain health.
The Heart and Stroke Foundation is committed to driving this change by raising awareness, funding more women-focused research, and working to change policies, systems, and attitudes — but we can’t do it alone.
February is Heart Month and I encourage everyone to join the conversation about women’s heart and brain health so we can live in a world where every woman gets the care they need. Together, we can beat health inequity.
Heart Disease and T2D Are Linked — And Proper Care Is Key
Living well with heart disease and type 2 diabetes is possible with careful disease management and care.
Tania Amardeil
Approximately 5.7 million Canadians live with diabetes, a lifelong condition where the body either doesn’t produce enough insulin (Type 1 Diabetes) or cannot use the insulin it has effectively (Type 2 Diabetes). We all know someone with this chronic condition, and with proper management, people with diabetes can live long and happy lives. However, it’s important to be aware of the risks and dangers that diabetes presents, and to take management of the disease seriously.
The perfect storm One of diabetes’ greatest dangers and complications is the effect it can have on cardiovascular health. Diabetes means that there’s too much sugar in the blood, and this sugar sticks to things, including proteins in the blood vessels, which weakens the blood vessels and makes them prone to cholesterol build-up. This can result in reduced blood flow or a sudden complete blockage if a blood clot forms. Diabetes thus increases the risk of high blood pressure, narrowing of the arteries (atherosclerosis), coronary artery disease, and stroke.
According to the Heart and Stroke Foundation, people with diabetes are
three times more likely to die of heart disease. They’re also at risk of developing heart disease at a younger age. Diabetes and heart disease share several risk factors, including high blood pressure, unhealthy weight, and high cholesterol.
Weldon Wadden, 75, of Cape Breton, N.S., experienced this convergence of health challenges firsthand. He had an aortic aneurysm in his 50s and later heart failure and a valve replacement. Sixteen years ago, he was diagnosed with Type 2 Diabetes (T2D) after being monitored for prediabetes for years.
The value of support “We didn’t realize that heart problems and T2D often go hand in hand,” says Nancy Wadden, Weldon’s daughter. Nancy has been by her father’s side throughout the ups and downs of managing his health conditions. From checking in on him and accompanying him to doctor’s appointments to helping him to manage his diet and medications, Nancy has provided vital support to her father.
Recently, she worked with his health team at the Cape Breton Regional Hospital’s Heart Function Clinic to fine-tune an optimal medication regimen, which has greatly eased Weldon’s symptoms — including sugar lows and frequent weakness and dizziness. Weldon’s blood sugar levels are now well-controlled through both medication and healthy lifestyle choices, including watching his diet, being physically active, and making sure to get enough sleep.
I feel wonderful now. I never thought the day would come when I’d feel like this again.
“I feel wonderful now,” says Weldon. “I never thought the day would come when I’d feel like this again.”
Instead of worrying about her father’s health, Nancy can now relax and enjoy more quality time with him. The pair loves to sit by the wharf, watching the fishermen come in and reminiscing about old times. They receive support from the Heart and Stroke Foundation’s Facebook groups, which provide valuable resources for both patients and caregivers. “It really helps to know that you’re not the only one going through it,” says Nancy.
If you or someone you love is managing T2D and cardiovascular disease, visit heartand stroke.ca
Sudden cardiac arrest (SCA) occurs when an electrical malfunction of the heart causes it to suddenly stop beating properly. There are no warning signs and it can happen to anyone, anywhere, anytime.
Having an AED Onsite Is Critical
The only effective treatment for SCA is a shock from an AED combined with high-quality CPR administered as soon as possible after a victim collapses. This ensures the most favorable outcome.
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Weldon Wadden with his daughter, Nancy Wadden.
Dr. Jason Dyck Director, Cardiovascular Research Centre, University of Alberta
Investigating the Link Between Diabetes and Heart Disease
Dr. Jason Dyck’s research focuses on preventing heart-related complications for people living with type 2 diabetes.
Diabetes is a major risk factor for developing cardiovascular disease.
In fact, Canadians with diabetes are over three times more likely to be hospitalized with cardiovascular disease than individuals without diabetes. As well, research shows that cardiovascular disease accounts for 44 per cent of deaths in people with Type 1 Diabetes and 52 per cent of deaths in people with Type 2 Diabetes.
High blood sugar is one risk factor for heart attack or stroke, but people with diabetes often have other risk factors. People who smoke or have a family history of heart disease or stroke are at even higher risk.
Dr. Jason Dyck is the Director of the Cardiovascular Research Centre at the University of Alberta. His research is focused on better understanding the relationship between type 2 diabetes and poor heart function, with the goal of discovering how to slow or prevent this complication. His team is studying diabetic cardiomyopathy, which happens when someone with diabetes has worsening heart function, even without having any other risk factors.
Understanding heart cell damage
betes Canada toward his research and believes that more awareness is needed regarding the far-reaching impact of diabetes. In fact, it has been estimated that if diabetes were eliminated, there would be a 19.1 per cent global decrease in the rate of heart attacks in women and a 10.1 per cent decrease for men.
“You don’t hear that someone died from diabetes, but they’re dying from the consequences,” says Dr. Dyck. “So, you may hear that a friend has died from cardiovascular disease. But if we had prevented or cured diabetes, this may never have happened.”
Dr. Dyck’s goal is to develop treatment strategies for patients at risk for, or who have already developed, diabetic heart disease.
Dr. Dyck and his team have identified a protein in the heart that’s found at a higher level in animal models with diabetes. This protein increases heart cell damage. Their research will improve understanding of how this protein damages heart cells, and will seek to prevent poor heart function during the development of diabetes. Dr. Dyck’s goal is to develop treatment strategies for patients at risk for, or who have already developed, diabetic heart disease.
“We’ve found that when we inhibit this specific protein, cardiac cells actually do better,” he says. “We believe that by inhibiting it, we can help improve heart function.”
Dr. Dyck is grateful for funding from Dia-
Wear Red Canada Day is celebrated annually on February 13 to raise awareness about women’s heart and vascular health. Events are held online and in communities across Canada to remind Canadians to be mindful, curious, and proactive in the management of their heart health and wellness.
There are so many reasons to wear red. Consider these alarming heart health facts.
Cardiovascular disease —
A worldwide killer for women
Globally, heart disease affects one in three women. Despite this, women everywhere are under-studied, under-diagnosed, under-treated, and
Funding diabetes research
Since 1975, Diabetes Canada has provided more than $150 million in research grants, awards, and partnerships to scientists across the country to improve the quality of life for people living with diabetes and to find a cure. Research areas include diabetes management, care and risk-reduction in fields such as biomedical, clinical, health services, and population health research.
“Dr. Dyck’s research is addressing one of the deadliest complications related to type 2 diabetes, and has the potential to dramatically improve the quality of life for millions of people in Canada living with diabetes, such as myself,” says President & CEO of Diabetes Canada Laura Syron. “That’s why we are so excited to invest in researchers like Dr. Dyck and his team as they work to advance these new discoveries and breakthroughs.”
“I’m a cardiovascular researcher, so I’m looking at different disease conditions. But if I talked to my clinical colleagues, I would surmise that most of the people they're seeing with cardiovascular disease also have diabetes,” says Dr. Dyck. “Funding from Diabetes Canada allows me to directly ask questions related to diabetes and how it relates to cardiovascular disease. I’m grateful to Diabetes Canada and to its donors for enabling me to do this work.”
ABCDESSS of staying healthy with diabetes
Ask your health-care team about your:
A1C target is usually 7% or less
BLOOD PRESSURE CONTROL aim for less than 130/80 mmHg
CHOLESTEROL
LDL cholesterol should be less than 2.0 mmol/L
DRUGS to decrease heart disease risk: Blood pressure pills (ACE inhibitors or ARBs), cholesterol-lowering pills (statins),medications that lower blood sugar with proven heart benefit, or ASA (Aspirin)
EXERCISE AND HEALTHY EATING regular physical activity and following a healthy dietary pattern
SELF-MANAGEMENT SUPPORT setting goals, and identifying barriers that may prevent you from reaching your goals
SCREENING OR MONITORING FOR COMPLICATIONS heart, feet, kidneys, eyes STOP SMOKING
under-aware when it comes to their heart and blood vessel health.
Women experience different heart attack symptoms than men Heart attack symptoms are not recognized in over 50 per cent of women. Most women report chest pain or discomfort, as well as feeling unusually tired and short of breath. It’s important to seek immediate medical attention if you suspect you or someone else may be having a heart attack.
Risk factors for heart disease affect women differently
Lifestyle and medical factors can contribute to a woman’s future risk of heart disease. Importantly, diabetes, high blood pressure, and smoking are more likely to cause heart disease or
stroke in women than in men. For example, women with diabetes are three times more likely to have heart disease than diabetic men. There are also specific risk factors for women in pregnancy and menopause. For example, complications that can occur during pregnancy, such as preeclampsia and gestational diabetes, among others, can increase a woman’s future chance of having heart disease or stroke.
80 per cent of a woman’s risk factors are preventable
Being active, eating well, managing stress, not smoking, and having regular check-ups to assess and treat high blood pressure, blood sugar, and cholesterol reduce a woman’s risk of heart disease.
— Did You Know?
This article was sponsored by Diabetes Canada
Abigail Cukier
Laura Syron President & CEO, Diabetes Canada
Genomics is Helping Improve Diagnosis and Treatment for Heart Patients
Heart disease patients often have genetic factors that increase their risk, which is why genetic testing is such a powerful tool.
Calgary-based biotechnology company
BioAro Inc. is on a mission to help patients who may be experiencing heart disease and people who may be at higher risk of developing heart disease. Heart Month brings more attention to this disease, which is growing every year. Cardiovascular diseases affect over three million Canadians, with over 750,000 Canadians living with heart failure. Additionally, over 100,000 Canadians are diagnosed with heart failure every year.
Understanding the role of genetics
Genetics plays a significant role in the development of heart disease — as often seen in South Asian Canadians, who are at 3 to 5 times higher risk of developing heart diseases versus other Canadians. Familial hypercholesterolemia is a genetic condition that causes high cholesterol, and if left
untreated, it can cause heart attacks in 30 per cent of women by age 60 and 50 per cent of men by age 50. It’s estimated that up to 50 per cent of patients with dilated cardiomyopathy (a type of heart failure condition where people don’t have a history of blockages in the heart arteries or haven’t had heart attacks) could have genetic mutations that could further increase their risk of sudden cardiac death.
Harnessing the power of precision medicine
"Genetic testing is a powerful tool to guide physicians in diagnosis, making precise medical predictions, individualizing therapy, and counselling on health risk assessment,” says Dr. Anmol Kapoor, a cardiologist and CEO of BioAro. “The goal of precision medicine is to provide the right treatment, at the right time, tailored to a patient’s individual needs, considering the unique genes and environment of each patient.”
As all tests are done in Calgary, rather than sent out of the country, BioAro can deliver results on a faster and more efficient timeline. The five major testing cardiac panels include heart failure, high blood pressure, sudden cardiac death, ischemic heart disease, and high cholesterol. Testing can be done with a simple cheek swab (done at home or at a designated clinic) or with a small blood sample collected at the lab/clinic. Reports are delivered in three to four weeks. BioAro also offers Genetic, Cardiology, and Dietitian consultations.
Cardiovascular diseases affect over three million Canadians, with over 750,000 Canadians living with heart failure. Additionally, over 100,000 Canadians are diagnosed with heart failure every year.
Q&A WITH CARDIOLOGIST DR. ANMOL KAPOOR
There’s a new way of diagnosing heart disease — genetic testing. For Canadians who experience heart failure, it’s important to understand their genetics and for health care professionals to know their genomics to support better patient outcomes and give patients the best options available.
How’s personalized medicine advancing for cardiac patients and what is BioAro Inc. doing to support quality of life for Canadians with cardiovascular diseases?
Heart disease has affected us all, whether personally or through a loved one. Approximately 1 million Canadians suffer from heart failure. Many of those people have a condition called dilated cardiomyopathy. Cardiomyopathies have a strong genetic association and tend to be linked with increased risk of heart failure and sudden death. Cardiomyopathies are one area that genomics is helping us identify these individuals at risk, as well as family members to implement better clinical management strategies. It’s important to triage these patients and provide genetic tests along with counselling in a timely manner. BioAro is the first Canadian biotech company that offers comprehensive assessment for cardiac patients using genomics and provides consultations. Precision medicine-based approaches can help us improve the quality of life and focus on prevention and management more accurately.
How is heart failure affecting Canadians and the Canadian health care system?
As the population ages, so does the diagnosis of heart failure. Heart failure is one of the top 5 causes of hospitalizations and readmissions in Canada. Currently, the Canadian health care system is facing a shortage of healthcare workers leading to improper management of patients with chronic diseases. This has a huge impact for individuals living with congestive heart failure, as patients with heart failure often require multiple visits to the hospital and are admitted for longer periods of time. Often, prior to diagnosis, an individual may develop symptoms of heart failure. However, by the time they go to the hospital, it s often too late for physicians to manage the condition in an outpatient setting. Heart failure is an expensive condition for the health care system and takes a toll on a person’s quality of life. Paired with long COVID-19 symptoms, the number of incidences is expected to increase further. Canada doesn’t have the infrastructure to manage such a significant increase of heart failure cases. We need to find a better solution for helping these patients in the community.
Discuss the collaboration with the DilWalk Foundation — what prompted you to launch this clinic?
As we’re aware, heart failure is on the rise in Canada. We need to focus on helping patients manage symptoms in the community before they get worse. This can be accomplished by supporting outpatient clinics with healthcare providers that are comfortable dealing with heart failure. This allows us to teach patients the importance of self-management and understanding the severity of their symptoms. This can help stop the cycle of readmissions and know that there is support available for them in the community. Canada may never have enough cardiologists to manage these patients, but nurses and other allied health professional can truly be an asset. By training these professionals, we can reduce the stress on the system. This is what led to the development of Alberta’s first Charitable Heart Failure Clinic in Calgary, as a pilot – to show that nurses and other health care providers can be trained and empowered to look after these patients with chronic diseases — reducing hospitalizations and readmissions. Thus far, this pilot project in partnership with the DilWalk Foundation has been very successful and prevented 100s of hospitalisations. DilWalk Foundation is a 100 % volunteer run charity, helping raise awareness of heart disease in vulnerable populations, such as visible minorities, women, and kids through various community initiatives. By implementing these types of pilots throughout Canada, we can help to reduce the burden off the hospital system and improve patient outcomes with heart failure. BioAro is proud to work with charitable organizations like DilWalk foundation and improve access to genetic testing for heart patients.
