The facts are heart-stopping.
Every 22 minutes a woman in Canada dies of heart disease.
What's even more shocking? Most of them don't have to.
We have one of the best healthcare systems in the world
and we're not serving women to be having a statistic like that.
Many of these are avoidable deaths
and we have to do better.
When it comes to heart health
women are practically invisible
under-diagnosed, under-treated, and often unaware.
Twenty-four thousand Canadian women die of heart disease every year
that's nearly five times more deadly than breast cancer.
So why is heart disease killing so many women?
We're going to speak to leading experts in women's heart health to find out.
Dr Paula Harvey is a cardiologist
and head of the Department of Medicine
at Women's College Hospital in Toronto,
When we really started to improve the outcomes
from cardiovascular disease in the 60s
all of the attention was on men
and there was no attention at all to the fact
that women also have cardiovascular disease
really it's only been in the last few decades
we're starting to understand that you're missing half of the world's population.
For women, heart disease can be like a ticking time bomb.
Diabetes and certain ethnic backgrounds increase the risk for some
but over a lifetime,
heart-protecting hormones fluctuate and decline in all women.
Especially as they enter menopause.
Estrogen levels drop and the risk of heart disease goes up
and that dangerous transition starts in a woman's forties.
Women are still not being educated
they're not being counseled
they don't understand the impact of our changing biology with age.
That puts them at cardiovascular risk.
Do you see patients who are surprised?
Who say I've been healthy all my life
why did this happen?
All the time, all the time.
I was still two months after my event reeling from that shock
Risa Mallory had a heart attack four years ago
when she was 61 years old.
I had this life-threatening event and so it shook me to the core.
At a support group in Ottawa survivors like Mallory deal
with the aftershocks of a heart disease diagnosis.
I didn't talk about it a lot until I got stronger.
Mallory says her heart attack started
with a discomfort in her chest
that came and went for days.
The fourth day I experienced chest pain it had changed
it was much more severe
I was feeling nauseous
and I had this sense of fight or flight.
Like I felt like I had to go somewhere
I don't know where or why
but I remember sitting in the car rocking and saying
we gotta go, we gotta go, we gotta go
next thing I do remember the nurse yelling at me
saying stay awake Risa, don't fall asleep, keep breathing, don't fall asleep.
Even more scary, Mallory has heart disease in her family
she's aware of her own risk
but she's still almost missed the signs.
I even asked my cardiologist
how are my organs not damaged
how do I not have brain damage
how much time did I have left to live
and the answer to the latter was minutes
and the answer to the former was you were just lucky.
The point is unlike what you see on TV
women don't typically have dramatic heart attacks.
Their symptoms can be different from men's
and may be attributed to stress and busy lives.
For example take a look at this
when a heart attack is looming
women may experience unusual fatigue, indigestion, anxiety, trouble sleeping
and even during a heart attack the symptoms can be subtle
too women often feel chest discomfort
shortness of breath
pain in their neck, jaw or, back.
Women can miss the warning signs
and often doctors do too.
What it tells us is that there is still a lot of inequalities and bias
at the community level and at the healthcare provider level.
Dr. Thais Coutinho is a cardiologist
and chair of the Canadian Women's Heart Health Center
at the University of Ottawa Heart Institute.
Coutinho says many women are in the dark in large part
because much of the medical community still is too.
That assumption that women may be small men
if it's applicable to men they may be applicable to women
still permeates through the cardiovascular research community.
And I do a lot of sex and gender-based research or women's specific cardiovascular research
and it's amazing the differences that you find if you look.
Good morning, doctor.
But traditionally heart research only focused on men
you see this model of the human heart
even though women's hearts and arteries are smaller
and plaque builds in different ways
it's why standard diagnostic tests
like angiograms and stress tests
are still often not sensitive enough to detect heart disease in women.
There's still cardiovascular research being done that is excluding women.
Coutinho says that has to change
all of the gaps that we know exist
awareness, diagnosis, treatment, care, rehabilitation, education, everything
it starts with knowledge.
For her not to listen to my symptoms was really concerning.
Samia Janna was 48 years old when her doctor dismissed
her concerns about her shortness of breath.
She was prescribed anti-anxiety medication
and told to take time off work.
I went back to her after a month
I said the symptoms are still there
she increased the medication and another time one month off from work
and then I went again and then another third month off from work
and still on anxiety medication
at that time I said no, I know it's not anxiety
I know myself just there's something wrong with my heart.
Blood tests didn't flag anything
but Janna pushed for an ultrasound
that revealed her heart was enlarged.
She ended up having open heart surgery twice.
It took time for me to let it go to let the anger go.
The last four years haven't been easy
but what she learned at a cardiac rehab program in Ottawa
is helping her get stronger mentally too.
Being between four walls
would have really increased the depression and the anger
and the anxiety and the loneliness.
So I joined the cardio rehab
if it wasn't for them I would have been in a very dark place.
Okay so we're going to start with our stretching.
Cardiac rehabilitation can be crucial for physical and emotional recovery
but women are up to 50 percent less likely than men to attend
cardiac rehab programs often because
they don't get referred to one.
It helps explain why women who have a heart attack
are more likely to die or suffer a second heart attack
compared to men.
So, what now?
Knowing all that we know and still don't know
what can women do to protect themselves while the medical system catches up?
The good news is you can dramatically reduce some major risk factors
by managing high blood pressure
not smoking and sticking to a healthy weight.
Another big one experts say advocate for yourself.
Urge your doctor to check your heart.
That I think is key, we need to be empowered.
Knowledge is power.
Advocacy is power.
It's amazing to be a woman
we just need to be aware of what happens across our life span.
Be ahead of the game.
It all comes back to saving lives
because most heart attacks don't have to happen
and for women especially
prevention starts when the threat to them
becomes more visible.
So Ioanna, we know the risk seems to increase as women age
but there is a concern right now about younger women.
That's right, Ian.
Experts are noticing an alarming trend among women in their 40s
many women in that age group are presenting at their doctor's offices
with high blood pressure, obesity, diabetes
and many are smoking.
All of these are risk factors for heart disease
now here's where the double threat comes in
as we mentioned in our report
levels of the heart-protecting hormone estrogen
start dropping in a woman in women in that age group
so they're already vulnerable
and research is already pointing to
a higher rate of heart attacks among younger women
so the threat seems to be playing out
all to say that experts are worried
and they really want to underscore the point that
the majority of heart attacks can be prevented
by sticking to a healthy lifestyle
and getting your heart checked regularly.
Thanks, Ioanna.